Care Home: St Dunstan`s

Similar services:

• Thorndene
• Sutton Lodge Nursing Home
• Wingham Court
• Heathfield
• Red Oaks
• Hothfield Manor Centre

What the care home does well St Dunstan`s continues to provide a high standard of care to the residents it supports. It is an excellently managed service that has very good and effective systems in place to monitor the quality of care provided. Every aspect of this inspection showed that the home is exceptionally well run and in the best interests of residents. There is strong evidence to show that the ethos of the home is open and transparent with the views of residents listened to and valued. Some of the residents commented: `Thank God for St Dunstan`s`. `The home could not be improved`. `The quality of care is very good`. `They look after me well`. Excellent social and leisure opportunities are available for residents both within and outside of the home including: archery, bowling, a lounge bar, a variety of holistic therapies, live music, acoustic rifle shooting, gymnasium, sports hall, craft workshop and swimming pool. All individuals` health and personal care needs are assessed and identified within comprehensive plans of care, which are regularly reviewed and updated. Residents have access to a wide range of health and social care professionals at St Dunstan`s. The home is a well maintained and comfortable home for residents to live. Residents are supported by a high number of dedicated, experienced and well trained staff who have developed close working relationships with the individuals they support. What has improved since the last inspection? Whilst no requirements or recommendations were made at the last inspection, the home has undergone extensive refurbishment at a cost of £2million. This has provided larger rooms for some residents with improved facilities and accessible en suite facilities. The home`s kitchens were awarded 5 `Scores on the Doors` for cleanliness and safe working practices, whilst they were given an `Excellent Clinical Quality Rating` by the Primary Care Team. As a matter of good practice, all 35 pressure relieving mattresses have been replaced and a pool of computers and other IT equipment has been made available for residents. What the care home could do better: No requirements or recommendations were made during this inspection. Key inspection report Care homes for older people Name: Address: St Dunstan`s Greenways Ovingdean Brighton East Sussex BN2 7BS     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Niki Rayner     Date: 2 8 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: St Dunstan`s Greenways Ovingdean Brighton East Sussex BN2 7BS 01273307811 01273302704 jacqueline.greer@st-dunstans.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: St Dunstan`s care home 77 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability sensory impairment Additional conditions: The maximum number of service users to be accommodated is 77 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Sensory impairment (SI) Physical disability (PD) Date of last inspection Brief description of the care home St Dunstans is a large home that provides both residential and nursing care for up to 77 residents with visual or physical impairment. St Dunstans is run by a not for profit charitable organisation that provides care to ex-servicemen and women who are visually impaired. The home is situated in its own grounds at Ovingdean, near Brighton. St Dunstans provides its own transport services and drivers to enable residents to go shopping in Care Homes for Older People Page 4 of 29 Over 65 0 0 77 77 Brief description of the care home Brighton, or participate in day trips. The home provides many facilities to enable residents to participate in activities, including a gym, sports hall, swimming pool and crafts workshop. Facilities are also provided to enable residents to accommodate guide dogs. Accommodation is provided in single, en-suite rooms, with a number of shared rooms available if required. St Dunstans is located over five floors, with residents accommodated on the first, second and third floor. Passenger lifts enable residents to access all areas of the home. A variety of communal space is provided in a large lounge/bar area, dining area and two further lounge areas. There is also a small seating area situated on each floor, and a further small dining area on each unit. There is an enclosed garden that provides a pleasant area for residents to sit, and a gardening club enables residents to participate in landscaping this area. The current fees range from £210.00 to £518.00 per week. Additional charges are made for newspapers, hairdressing, private telephone and some activities. 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 reader should be aware that the Care Standards Act 2000 and Care Home Regulations 2001, uses the term service user to describe those living in care home settings. For the purpose of this report, those living at St Dunstans will be referred to as residents. This report reflects a key inspection based on the collation of information received since the last inspection, a review of the homes Annual Quality Assurance Assessment (AQAA) and an unannounced visit to the home on Thursday 28th January 2010 between 09:50hrs -15:30hrs. Due to the size of the care home, this inspection was carried out by two Inspectors. The inspection included a tour of most areas of the home, discussions with eight residents, five members of staff and the Registered Manager. In addition, a number of the homes records were viewed including: four individual care records, health and Care Homes for Older People Page 6 of 29 safety records, records of complaints, medication records, staffing records and questionnaires sent out by the home as part of their own quality monitoring systems. Interaction between residents and staff was also observed. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: 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. Care Homes for Older People Page 8 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Excellent systems are in place to ensure that only residents whose needs can be met are admitted to the home. Evidence: It is a stipulation of St Dunstans, that all people who use its services must be members of the charity. This includes those who wish to use it as a holiday home, for respite care, or for rehabilitation purposes. The Manager explained that no person can become a permanent resident of the home unless they have used the organisations services before. This means that each prospective resident has a good understanding of what the home is like and what it can provide, prior to moving in. This also means that nursing and care staff have a sound understanding of individuals needs. St Dunstans employs a dedicated social worker and team of welfare officers throughout the country, who are responsible for carrying out pre-assessment interviews with all prospective users of the service. This includes collating detailed Care Homes for Older People Page 11 of 29 Evidence: information about each persons background, their health and personal care needs, social care needs and individual needs and choices. Evidence seen showed that this information is thorough and is collated from the individual themselves, their relatives and any other health or social care professional involved. This information is then reviewed by a multidisciplinary admissions panel board, who ultimately decide whether or not St Dunstans can meet their needs. The AQAA stated that all residents are admitted for a 4 week trial period prior to being considered as a permanent resident. A comprehensive contract outlining what the home can offer and at what cost to the resident is supplied to all prospective residents. 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. Staff provide sensitive and dignified support to meet the individual needs and preferences of residents. Residents are supported to access a range of healthcare services to meet their physical and emotional well-being. Residents are safeguarded by the homes policies and procedures for the safe administration of medicines. Evidence: Four care records were viewed during this inspection; two were for residents requiring nursing care, whilst the other two were for those in receipt of residential care only. Residential care staff were commended for the way in which their care plans had been individualised to include a personal history of each person. All care records were found to be sufficiently detailed and based on individuals assessed needs. All were easy to read, follow and understand. Risk assessments had been undertaken to identify and minimise any potential risks in respect of mobility and the prevention of falls, nutritional care needs and pressure area care. The Manager stated in the AQAA that the home aims to ensure that any risks are minimised, whilst facilitating independence where possible. There was evidence to show that all care Care Homes for Older People Page 13 of 29 Evidence: records had been regularly reviewed, whilst the AQAA stated that a full formal written review of all care is undertaken with the resident and relatives every six months. Clear daily records are kept. Residents, staff and care records confirmed that individuals health care needs are met well by the home. A General Practitioner from a local surgery visits twice a week, whilst input from other healthcare professionals is requested as required including: a wound care specialist, continence advisor, physiotherapist, optician, chiropodist and audiologist. Some of these services are offered in-house. In addition, the home pays a retainer for a dietician to visit the home every two weeks to assess and advise on individuals nutritional care needs. Residents also said that they are supported to a number of external healthcare appointments by staff such as local out-patient hospital appointments. The AQAA stated that in response to an audit conducted by an external Clinical Quality Review Nurse from the Primary Care Team (PCT), they sought advice from a Tissue Viability Nurse in respect of all pressure relieving equipment. As a result of this and as a measure of good practice, all pressure relieving mattresses were replaced. St Dunstans has been awarded an Excellent Clinical Quality Rating by the PCT. A sample of the homes medication systems were viewed on one of the allocated nursing floors. This included the viewing of some medication administration records (MARS), the medication cupboard and a small number of controlled medicines. It was noted that in one instance a Registered Nurse had crossed through a prescribed medicine on the MARS, following some confusion as to whether or not it had been discontinued. The Practice Development Nurse was clearly able to explain this to the Inspector and evidence that the appropriate action had been taken e.g. clarification had been sought from the GP and pharmacy and records amended accordingly. No other concerns were raised. All rooms are for single occupancy, unless two people choose to share, whilst all personal care is supported in residents own bedrooms and/or bathrooms discreetly. During the inspection, all residents were seen to be treated with dignity and respect by all staff. They were addressed by their chosen term, some by their Christian names whilst others preferred to be called by their surnames. Without exception, all residents spoke highly of the way in which they are treated at St Dunstans. Some of their comments included: They look after me well The standard of care has improved greatly Care Homes for Older People Page 14 of 29 Evidence: The homes AQAA stated that the home has introduced a dignity champion role, which is currently being developed. The Manager explained that a member of staff nominated themselves for this role, which involves attending dignity in care seminars and meetings locally in order to share and promote best practice. The Manager said that as this role progresses, the home hopes to introduce a dignity care plan. 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. Residents are supported to take part in an excellent range of activities to lead fulfilling lives. They play an active and fulfilling role in their community and are supported to maintain positive relationships with family and friends. The ethos of the home promotes the right of residents to make choices in all aspects of their lives. Evidence: St Dunstans provides specialised care, accommodation and support for people who are visually impaired. The home has been specifically built and adapted and therefore contains all the necessary aids and equipment needed to support residents to live as independently as possible. The AQAA states that a dedicated activities coordinator is employed who is responsible for arranging a wide range of internal and external recreational activities. These include: day trips out in the homes own transport, shopping trips, theatre visits, indoor/outdoor bowls, archery, bingo, acoustic rifle shooting, in-house clubs, live music, in-house bar, on site swimming pool and gym, transport to local church services and use of the onsite craft rooms (pottery, wood work, painting and other crafts). In addition to this, an activities schedule for February 2010 was seen on the day of inspection, which advertised: yoga, poetry reading, dominoes, a visit to Hove Care Homes for Older People Page 16 of 29 Evidence: museum, dance lessons, gala ball, valentines quiz and a visit to the circus. Additional therapies are also available to residents for a small fee such as reflexology, Swedish massage and Indian head massage. There are also areas for residents to use computers and other specialised visual equipment, as the home also contains a rehabilitation centre. Residents confirmed that their families and friends are very welcome in the home and St Dunstans tries to ensure that these links are maintained, particularly as many of the residents come from different areas across the United Kingdom. The home is able to provide accommodation for family members to stay when necessary. The homes AQAA states that St Dunstans has increased their team of local community volunteers and that it has obtained the Investors in Volunteers award. Residents confirmed that they are able to make a number of different choices and decisions about their lives. They can choose how much they wish to be involved in, when they go out, who they see and where they go. They can also receive assistance with their money and handling other personal finances as the home has a dedicated finance officer and a wills and trusts coordinator. Residents meetings are held monthly. Minutes of the most recent (7th January 2010) were seen on the day of inspection. These showed that the meetings are well attended by residents and lead by the residents themselves alongside a team of key staff such as the activities coordinator, residential manager, maintenance manager, social worker and operations manager. The minutes showed that any matters arising are promptly dealt with. The Manager also commented that these minutes are also produced in Braille and audio format. Due to the size of St Dunstans, an in-house catering company provides all the meals for both residents and staff. The home has its own kitchens where the meals are prepared and transported to the dining areas, staff canteen and various other small serveries on the residential and nursing floors. The homes AQAA states that the home was awarded 5 Scores on the Door for cleanliness in October 2009 and that the most recent visit from the Environmental Health Officer raised no concerns. A minimum of three choices are available at each meal and the needs of vegetarians are catered for. Menus are reviewed by a dietician and are rotated on an eight weekly basis. Hot and cold drinks are available upon request and the services of a dietician are readily available for all residents. Residents feedback about the food provided was Care Homes for Older People Page 17 of 29 Evidence: generally very positive. Indeed it was minuted in the most recent residents meeting that a greater selection of meat had been on the menu over Christmas and the New Year. 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. The home has good systems in place to ensure that all complaints are investigated and responded to appropriately and within a set timescale. Residents are protected from potential harm, neglect and abuse through the homes robust policies and procedures and through staff receiving the appropriate training. Evidence: The AQAA states that the home has a comprehensive complaints policy in place, which was last reviewed in July 2009. This is made available to residents and is also printed in the St Dunstans review magazine. Residents said that their key workers will assist them to make a complaint if required. The homes AQAA identified that they have received three complaints in the past 12 months. All records relating to these were viewed on the day of inspection. All three had been thoroughly investigated by the Manager with clear, detailed and transparent records of each of the investigations kept. Two of these complaints were in respect of care. Two were upheld and the appropriate action taken. Staff training records and the homes AQAA evidenced that all staff have received recent training in respect of Safeguarding Vulnerable Adults and the Mental Capacity Act. The AQAA states that there is a clear procedure for reporting any signs of suspected abuse and a whistle-blowing policy in place for staff, which was last reviewed in July 2009. No safeguarding alerts have been made in the past 12 months. Care Homes for Older People Page 19 of 29 Evidence: The Manager reported to the Commission and the police, a series of incidents which occurred over Christmas. Three people (one of which was a resident in receipt of residential care) reported that money had gone missing from their personal belongings. Records showed that these allegations were thoroughly investigated, which included taking statements from residents and staff. To date, it has not been possible for the home to resolve these matters, however all residents and staff have been informed of this matter and residents have been reminded of the need to secure their valuables with the cashier, lounge desk or reception. In addition, the local Police Community Support Officer has been invited to visit St Dunstans on a more regular basis so a uniformed presence can be seen. The Manager and Security Manager consider that this may not only act as a deterrent, but will also promote the seriousness of this matter. The Manager has assured the Commission, that this issue will be closely monitored. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. St Dunstans is a clean, well maintained and fit for purpose place for residents to live. Evidence: St Dunstans has been specifically designed to care for people who have visual impairments and contains a variety of specialised equipment and aids. Since the last inspection, a £2million refurbishment of both nursing floors has been completed. This has facilitated the provision of larger rooms for residents with disabled access en-suite facilities to all bedrooms. Overhead tracking hoist systems have been installed to facilitate ease of transfers for residents with reduced mobility. Each of the rooms have been rewired and a new radio system, internet access, nurse call system and lighting. All of the refurbished en-suite bathrooms have had pressalit height adjustable sinks, grab rails and showers installed so that they can be manoeuvred into a position that best suits the needs of the individual, thus promoting independence. The home employs a team of maintenance staff to ensure that the environment is well maintained in a safe and appropriate manner for residents. There are additional communal bathrooms and toilets for residents use throughout the home. A team of housekeeping staff are employed to maintain a clean odour free environment. The AQAA states that all staff, including housekeeping staff, are trained in infection control Care Homes for Older People Page 21 of 29 Evidence: and hygiene maintenance, whilst the home has a designated infection control nurse champion. Laundry services are provided in house and machinery used has a sluice facility. Soiled or infected linen is laundered in biodegradable bags and is transported to the laundry via a laundry chute to prevent cross infection. All areas of the building are wheelchair accessible and there are three passenger lifts available. Communal areas have a loop system in place and portable loop systems are available for residents who require these in other areas. The building has been designed with the needs of visually impaired residents kept uppermost through the use of appropriate signage, hand rails, flooring, colour contrasting and furnishings and lighting. There is 24 hour fire safety and security staff on duty and the grounds are monitored by CCTV cameras. A smoking shelter has been provided in the inner garden for residents use so that non smoking residents are able to remain in a smoke free environment. All areas of the home seen were found to be well maintained and clean to a high standard. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported by a highly skilled, well trained and dedicated staff team who continue to work hard to meet individual needs. Residents are supported and protected by the homes robust recruitment procedures. Evidence: St Dunstans employs a very large staff team of over 200 people who are based at Ovingdean. In addition to the Registered Manager, 18 Registered General Nurses (RGNs)and 59 care staff are employed. The AQAA stated that the home employs a larger than required number of nursing and care staff to ensure a high level of service delivery. The Manager said that resident dependency levels are assessed on a monthly basis and staffing levels are monitored against these to ensure that they have sufficient staff to meet residents needs. The AQAA and a number of care staff spoken with confirmed that all care staff are trained to a minimum of NVQ level 2, as St Dunstans have stipulated this as compulsory training. A training and development manager and a practice development nurse are both employed to ensure that staff development is maintained. There are a number of training topics on which annual attendance is considered to be compulsory, these include Safeguarding Vulnerable Adults, food hygiene, manual handling, infection control and fire training. Additional training sessions are delivered including dementia awareness, common conditions of residents, oral hygiene and any topic that Care Homes for Older People Page 23 of 29 Evidence: staff identify an interest in. The AQAA states that the charity has supported a large number of staff to develop beyond the requirements of their role. This was confirmed by a number of staff spoken with. The AQAA states that there are stringent recruitment policies and procedures in place to ensure that staff employed and volunteers are thoroughly vetted and references are checked prior to commencing employment. Two personnel records viewed on the day of inspection confirmed this. Records and staff confirmed that a comprehensive induction and mentoring programme is in place for all new staff, which provides not only induction to the job role, but to the charity and its ethos. The AQAA stated that the home has introduced clinical supervision for all grades of care staff. Staff now rotate between nursing and residential care so that they work as a more cohesive team and get to know all residents equally well. Since the last inspection, the home has fully implemented the Gold Standards Framework for End of Life Care. Feedback from residents in respect of all staff working at the home was exceptionally positive. Some of their comments include: They look after me very well. They always respond to the call bells. Thank God St Dunstans is here. 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. Both residents and staff benefit from an excellently managed and organised home. The views and rights of residents underpin the ethos and development in the home. Evidence: The Registered Manager is an RGN with 19 years experience of managing care homes. She has worked at St Dunstans for over 14 years. She holds a University Certificate in Residential Management and has recently submitted a dissertation for a Masters Degree in Clinical Studies and Management (this was funded by St Dunstans). The home has very good and effective systems in place to monitor the quality of care provided, which includes seeking feedback from all people using the service, their friends and relatives and other stakeholders. Comments sheets were seen in most rooms and in reception for completion by anyone who would like to give feedback. The AQAA states that a twice a year they randomly select a number of beneficiaries across the charity to gain their feedback. Care Homes for Older People Page 25 of 29 Evidence: In addition, every new resident is asked to complete a satisfaction survey after nine months of living at the home. One of these was viewed on the day of inspection, which was noted to be very positive. Some of their comments included: I have received excellent care and help. (the admissions process) was Brilliant. I have met other St Dunstaners whilst on holiday, thus affirming a bond. The AQAA states that all residents in care are asked to complete an annual quality assessment questionnaire, which is carried out by a volunteer who is not employed by the charity, so that residents feel able to voice concerns without fear. This was confirmed by residents. Regulation 26 visits are carried out monthly and the records for these visits were viewed. A new format has recently been introduced. This is an improvement in that there is now an action part to the form. This is used if a shortfall is identified and is a way of ensuring the service is continually looking for areas to improve and then take the necessary action. Every aspect of this inspection showed that the home is exceptionally well run and in the best interests of residents. There is strong evidence to show that the ethos of the home is open and transparent with the views of residents listened to and valued. Other comments made by residents during the inspection included: The home could not be improved. The quality of care is very good. Nothing to improve. St Dunstans employs a full time Health & Safety Manager who is responsible for all aspects of health and safety throughout the home, whilst a dedicated maintenance team of staff are employed to carry out checks on all systems and equipment within the home. All areas of the home seen and a sample of health and safety records showed that St Dunstans is maintained to a very high standard throughout. It continues to be very proactive in its approach to maintaining the health and safety of residents and staff. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!