Care Home: St George`s Lodge

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What the care home does well The home is well decorated to a good standard with attractive communal areas and bedrooms. Residents are very well cared for and their health and social needs are met in full. All residents spoken to praised the staff and were complimentary about the service they received. Residents are encouraged to pursue a wide range of activities, both in the home and wider community. The activities programme is well thought out and caters to the varied needs of the residents in the home All pre-admission assessments and care plans are in good order and focus on individual needs, diversity and choice. Staff have the opportunity to participate in a range of training appropriate to the specialist needs of the residents. Management at the home ensure they are up to date with legislation and best practice through attendance at relevant training and local forum groups. Administration and office records are in good order with audits in place to ensure records are completed in full and kept up to date. Overall St Georges Lodge home offers a very high standard of care to its residents. What has improved since the last inspection? Since the last inspection the home has undergone some refurbishment and renovation works. This will continue as part of the homes annual maintenance schedule. The home has improved the Dietary Requirement form to assess clients food requirements on admission. This has a more comprehensive layout to enable the chef to plan meals for individual clients. The home has implemented a more thorough care needs assessment for residents prior to admission. This ensures the home can fully meet the residents needs. The home has updated their service user guide, statement of purpose and complaints procedure. What the care home could do better: The manager intends to collate quality assurance information gained throughout the year and ensure it is published. Continuous monitoring of the service will help to maintain and improve upon the high standards achieved. Key inspection report Care homes for older people Name: Address: St George`s Lodge 46 Chesswood Road Worthing West Sussex BN11 2AG     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: Beth Tye     Date: 2 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 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: St George`s Lodge 46 Chesswood Road Worthing West Sussex BN11 2AG 01903820633 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Bushby Care Limited care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 26. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home St Georges Lodge is a care home registered to accommodate up to twenty-six residents in the category of old age. It is a detached property, located in East Worthing approximately one mile from the town centre and relatively close to the sea and parks. The accommodation consists of twenty-six single bedrooms, the majority of which are en-suite, and is arranged on two floors. There is a passenger lift to the bedrooms on the first floor, and a large garden/parking area to the front and the sides of the building. Bushby Care Ltd. privately owns the service. 0 Over 65 26 Care Homes for Older People Page 4 of 29 Brief description of the care home The current fee charged is #331-#500 per week 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 star. This means the people who use this service experience excellent quality outcomes. The unannounced inspection visit was carried out by Ms Beth Tye on 22nd Jone 2009 and lasted 4.5 hours. The visit was arranged to assist the Commission in assessing the homes compliance with the key standards of the national minimum standards for care homes for older people. Planning for the visit took into account information received on the service since it opened. The Annual Quality Assurance Assessment was returned to The Commission for Social Care Inspection (CQC) and informed us areas of improvement, which have been carried out and also identified areas for further improvement. Survey forms received from people living in the home, relatives and members of staff also contributed to our planning. Care Homes for Older People Page 6 of 29 On the day of the visit the inspector spoke at length with the manager and the owner, who was also at the home on the day. Residents living at the home, staff working at the home and visitors were spoken with to gain their views of the service, all comments were positive and all residents spoken to said they enjoyed living at the home. Four sets of admission assessments and the individual plans of care for people living in the home were looked at. A case tracking exercise for these residents was undertaken to examine how their assessed needs were being met. Other records sampled included recruitment and training records for four members of staff, the supervision plan, the record of complaints, quality assurance records, regulation 26 reports and records relating to health and safety issues in the home. The premises were viewed including communal areas, kitchens, bathrooms and bedrooms. A number of interactions between people living in the home and staff, arrangements for lunch and medication dispensing were 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. 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 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 9 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. Quality in this outcome area is good Residents were not accommodated in the home without a full assessment of their needs being carried out. This judgement has been made using available evidence including a visit to this service. Evidence: St Georges Lodge provides prospective residents with detailed information regarding the home prior to admission. This enables people to make an informed choice about moving into the home. Information is provided in a comprehensive Service User Guide and a Statement of Purpose. The manager stated in the AQAA (Annual Quality assurance Assessment), that both documents are updated regularly. Care Homes for Older People Page 10 of 29 Evidence: Residents spoken with said they had made a choice to live at the home and had received information regarding the facilities and services available. Four pre-admission assessments were looked at during the visit. They were clear, very detailed and were specific to the individuals. The assessments seen focus on the outcomes for individuals in health, personal care, social interests, diversity and family involvement. It was noted from the care plans seen during the visit that prospective residents and/or their families are given the opportunity to visit the home prior to admission if they chose to. Two residents confirmed that their families had seen the home prior to their admission. The AQAA states We offer prospective residents a trial period before they make a decision to stay on a permanent basis. All information about the service is available in bold print. St Georges Lodge offers respite care but not intermediate care. Care Homes for Older People Page 11 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. Quality in this outcome area is excellent Staff have appropriate training and information to ensure they are able to meet residents health needs. Medication is dispensed in line with the homes policies and procedures. Current care practices ensure residents feel they are treated with respect and their right to privacy has been upheld. This judgement has been made using available evidence including a visit to this service. Evidence: During the visit we looked at four care plans. Each care plan contains relevant details relating to the residents health needs and social well-being, they also detailed all aspects of health, personal and social care and the actions staff needed to take to meet these needs. Information seen on care files was up to date and easily accessible. There was Care Homes for Older People Page 12 of 29 Evidence: evidence to demonstrate that staff undertake regular care reviews for residents, and up date the care plans as changes occur. All aspects of care planning are agreed prior to admission and again during regular reviews, demonstrating those residents and their families are encouraged to participate in decision making. One resident commented The manager came to talk to me last week about my care plan, I was able to look through it and ask questions. I know whats in it and have agreed to everything thats written down. Individual risk assessments are in place, for example: risk of falls, pressure area damage and nutrition and action taken is recorded. Staff reported that this gives them a better understanding of need and responses in addition to supporting residents to maintain independence safely where possible. Records showed that residents have access to other community based health professionals as required. These include a physiotherapist, the hospital stroke team, dentist, and optician, CPNs, speech therapist, audiologist chiropodist and community nurses. Care records demonstrated that the care provided was specific to individual needs and links are established with community health professionals to provide this. One residents records showed her health needs following a stroke. The stroke team were called in to advise and monitor her. In addition to her care plan, specialist recording charts were devised to ensure all care practice was monitored and relevant. These were seen to be up to date and in good order, demonstrating the staff in the home are clear and accountable about the care they provide. Staff complete a full induction and mandatory training programme. Training is also provided as required. Any training the management team completes is cascaded down to the team. This training provides staff with the skills and knowledge base to respond appropriately to residents specialist health care needs. Case tracking, feedback and discussion with the residents and their relatives confirmed good practice is maintained in the home and residents are treated with dignity and respect. Service users said the home is wonderful, the best thing I ever did was come here and the staff are so good, I never have to wait around for anything. Another said Care Homes for Older People Page 13 of 29 Evidence: Nothing is too much trouble for the staff here; they give us everything we need. Residents confirmed they have a choice of baths or showers (some rooms have ensuite showers) and are supported to maintain independence in personal care needs. One resident said I can do it myself most of the time but if I have an off day staff are always on hand to support me. The medication administration procedures were discussed with staff and policies and procedures are in place to ensure safe medication administration. A random selection of medication was checked and found to be in order. Medication administration charts are completed correctly, which indicated that residents are receiving their medication as prescribed. Photographs of residents are displayed on blister packs as an extra safeguard towards safe administration. Records seen were in good order and up to date, demonstrating staff follow appropriate procedures. One resident had chosen to self administer some of her medication. A risk assessment and disclaimer had been signed by involved parties and records demonstrated this was reviewed appropriately. This practice promotes independence for residents who have the capacity to manage their own medication. Care Homes for Older People Page 14 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. Quality in this outcome area is excellent Residents find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social and recreational interests and needs. Residents maintain contact with family and friends Residents receive a wholesome appealing balanced diet in pleasing surroundings. This judgement has been made using available evidence including a visit to this service. Evidence: An on-going programme of activities are organised at the home, offering stimulation to those residents who are less able to explore interests outside the home. Hobbies and interests are detailed on care plans to ensure the activities provided are in line with personal interests and needs. Sufficient staff resources are provided to allow time for one to one activities and stimulation. The home operates a key worker system which promotes closer relationships with staff and residents, so needs and preferences can be shared. Care Homes for Older People Page 15 of 29 Evidence: One staff member said often in the afternoon we are able to sit with the residents and just talk or do activities. It means we all get to know them well and understand them better. The AQAA stated We continue liaising with outside companies on a regular basis. These include Able Angels, RNIB, Mobile Library, Optical Health call, Reminiscence exercises, Fashion Shows and Music entertainments. This allows all residents to have continual daily interests catered for. We have implemented armchair exercises with an assistant physiotherapist. This has proved popular and useful. One resident said I have an interest in steam railways and a member of staff managed to find a DVD series for me. I love watching it as Im not able to go out too much anymore Recently some of the male residents had requested a pub lunch. This was organised and the manager said was very much enjoyed by those who participated. Religious and cultural needs are identified as part of the care planning process. The staff escort individuals to religious services in the community as requested. An activities plan is on display in the home to enable residents to plan their time. However on the whole, routines are flexible to meet residents needs. Residents confirmed that they can choose what they want to do as far as social events, routines and also what times they go to bed and get up in the morning. Flexibility enables individuals to have choice and express a preference in their daily lives. Residents and relatives confirmed that the visiting arrangements for the home are open and visitors can come and go as they please and are made welcome by the staff. Feedback forms confirmed relatives felt welcomed and involved by the home. During the visit staff were observed interacting with the residents. They knocked on doors prior to entering, knelt down to their level to converse with them and offered choice where possible. Staff were seen throughout the day being respectful, kind and sensitive to residents needs. Care plans showed that prior to admission the level of involvement and information sharing with the family is agreed with the resident and recorded. This is regularly reviewed as part of the care planning process. Care Homes for Older People Page 16 of 29 Evidence: Residents spoken with confirmed they have meetings on a regular basis, so they can comment on how they view the home and contribute to decision-making. The menu offered at St Georges Lodge offers a wide range of balanced, home cooked food. The cook is experienced and qualified to fulfill her role. When spoken with during the visit it was clear she was familiar with dietary requirements of the residents. The menu offered at the home takes in to account the preferences of residents and specialist dietary needs, all of which are recorded on daily records and care plans. This promotes choice for the residents and provides an opportunity for them to eat what they prefer. An alternative meal is on offer at lunchtime and teatimes. Residents spoken with said they really enjoyed the food and it was marvellous. The atmosphere during lunchtime was very relaxed. Residents and staff interacted and staff were observed offering choice and prompting residents [respectfully] One resident spoke to staff about her birthday celebration the previous day and how she had shared cake and sherry (provided by the home) with her friends and family. She stated I had a wonderful time. Everyone was so kind Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good Residents and their relatives know that their complaints will be listened to, taken seriously and acted upon. The registered provider has ensured that residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. Evidence: The home has a complaint procedure, which is outlined in the statement of purpose and displayed throughout the home. Complaints are recorded and investigated with feedback to complainant within 28 days with the actions taken in line with the homes policy and procedure. All residents spoken with during the visit said they knew who to complain to and that they would not hesitate to do so if they thought it appropriate. A complaints log is kept in the home and was found to be up to date. Responses were in line with the homes policies and procedures. Care Homes for Older People Page 18 of 29 Evidence: Complaints are a standing item on the homes resident meeting agenda to enable residents to feedback their opinions. Staff induction and training records indicated that all staff have received training in safeguarding vulnerable adults. All training is up dated on an annual basis in line with best practice and legislation. At induction of new staff the Whistle Blowing Policy and the No Secrets Policy are pointed out in detail. All staff receive a copy of the Whistle Blowing Policy. The AQAA stated St Georges Lodge Philosophy of care outlines the policy regarding prevention, recognition and management of risk and potential for abuse. Records relating to the homes recruitment procedure were examined. These demonstrated that all staff under-go appropriate checks prior to employment and the recruitment procedures for the home are robust. The promotion of individual rights is promoted in the home through one to one key work sessions, regular residents meetings and monthly regulation 26 audits. Links with an advocacy services are available to all residents. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good The home was clean, tidy, well maintained and free from offensive odours. The bathing facilities are able to meet the needs of all residents. Equipment and safety checks necessary to ensure the welfare of the residents are in place. This judgement has been made using available evidence including a visit to this service. Evidence: On the day of the visit the home was found to be clean, tidy and free from offensive odours. The premises is a large converted house, which gives a homely, domestic feel. The decor and furnishings are comfortable and well maintained. The home is well lit, clean, and tidy and smelt fresh throughout. Some residents bedrooms are en-suite with shower facilities and toilets. All residents bedrooms are personalised with pictures and possessions from home. One resident had a photo montage on her wall of all her family members. In the centre was an enlarged photograph of her on her wedding day which she said the Care Homes for Older People Page 20 of 29 Evidence: owners had got especially done for me. She commented that looking at the photos each day is what keeps me going, it is really wonderful Since the last inspection the home has undergone continual redecoration and refurbishment. The AQQA states We have an ongoing plan of redecoration and refurbishment. We have new curtains in the dining room with a special lining to shade sunlight in the summer. Individual rooms have been redecorated where appropriate and carpets replaced. 26 new UPVC windows have been installed which are draft free and easy to open or close. The lounge and dining room have new chairs and tables. We have purchased new patio furniture for the garden. We have 3 new wooden benches with tables. The side garden has been recently fenced to allow more privacy when service users are on the patio area. During the visit resident were observed sitting in the garden which is attractive and provides suitable seating, tables and shade for the residents, who wish to sit outside during the summer months. Regular health and safety checks are undertaken, including risk assessments for the environment. The owner undertakes the majority of maintenance in the home or contracts specialists as required. This ensures the premises are well maintained and safe. Various moving and handling equipment is available in the home. Staff had received training in the safe use of this equipment. Some beds could be adjusted in height. Hand-rails, raised toilet seats and frames are available through out the home. Training records seen during the visit demonstrated that staff has undertaken training in health and safety and infection control. They were observed complying with correct hygiene procedures and wear protective clothing. Anti bacterial hand gel and plastic gloves were seen in all communal areas, in addition to bathrooms and residents rooms. Care Homes for Older People Page 21 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. Quality in this outcome area is excellent The staff numbers and skill mix are appropriate to meet the needs of the residents accommodated. Staff receive mandatory and specialist training and a high proportion of them had completed NVQ training. This judgement has been made using available evidence including a visit to this service. Evidence: Staff rotas reflected that there are enough skilled staff on duty at all times in the home. There are five care staff on most shifts. Both staff and residents fed back how this had helped to allow more time for activities and one to one care, particularly in the afternoons. In addition, the home has dedicated catering and house keeping staff which enables care staff to focus on their roles and responsibilities providing care for residents. Feedback from surveys and during the visit highlighted that staff are skilled and competent in their roles. Comments made about the staff by the residents and their families included they are kind and patient, compassionate, my dignity and privacy Care Homes for Older People Page 22 of 29 Evidence: is very much respected, and all the staff are very helpful and really know what they are doing. This was supported by observation of care practice and examination of care records during the visit. Training records and four staff files were looked at during the visit. They showed that staff have received induction training which includes all aspects of care in the home, health and safety and best practice guidance. The staff induction pack includes reference to appropriate policies and procedures and a checklist covering all aspects of the home. The mandatory training for staff covers fire safety, manual handling, health and safety, adult protection and infection control. Records show that in addition the home has exceeded the target of standard 28.2 by ensuring more than 50 of staff are trained to National Vocational Training level 2, 3 or above. Since the last inspection two Night staff members have gained a Night Care Awareness Certificate. The home has also improved their dedicated Key Worker System, to enable more one to one time with residents. Recruitment procedures were found to be robust and in line with the homes recruitment policies. All staff files seen were found to contain the necessary documentation required by Schedule 2 of the Care Regulations. The owner stated that in the interests of the residents the home does not use agency workers. This ensures all care provided is consistent as staff know the residents and what they need. Two members of staff were spoken with during the visit. They confirmed that they have undertaken relevant training and attend regular supervision with the manager. Staff also confirmed they receive an annual appraisal. Documentation to support this was seen during the visit, and found to be up to date and in good order. Care Homes for Older People Page 23 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. Quality in this outcome area is excellent Residents and staff benefit from the home being run by an experienced and qualified manager. Various quality audits and action plans are carried out in the home throughout the year. The home has good systems in place to protect the health and safety of the residents. This judgement has been made using available evidence including a visit to this service. Evidence: The registered manager of the home is experienced and qualified to undertake her role. The Manager holds NVQ3, 4 and the RMA. Both Deputy Managers hold their NVQ3 and continue to update their knowledge. The administrator/owner of St Georges Lodge holds RMA certificate and is RGN/DN. Care Homes for Older People Page 24 of 29 Evidence: The management system at the home ensures there is always a senior staff member on duty. This is supported by an out of hours management on call system. The AQAA states that the manager and owners attend regular training in line with legislation and best practice to ensure the home provides high quality care to its residents. The manager has five afternoons per week supernumerary to complete her managerial duties and support staff as required. The owner and registered individual for the home are very involved in service delivery and are responsible for completion of administration at the home. She has membership to West Sussex Care home Forum which informs her of new care related developments and legislation. Staff spoke very highly of the manager and owners, they confirmed they are trained and feel very much supported. Staff informed the inspector that hand overs occur following each shift, supervision and staff meetings are held regularly. Records and meeting minutes confirmed this. Feedback from staff demonstrated a commitment to meeting residents individual needs and preferences on a daily basis. Quality assurance at St Georges Lodge is undertaken in various ways. The home sends out annual questionnaires to involved parties, the results of which are collated and kept on file. It was recommended during the visit that these should be on display for involved parties to view. In addition the home holds regular meetings for residents, to input about how the home can be improved upon and to involve them in decision-making processes relating to changes. The owners carry out a monthly audit through the year (Regulation 26 reports) and implements change were necessary to improve services. The manager and owners also talk, informally to residents and visitors, gaining their views on the facilities and services at the home. The inspector found there is a strong emphasis on residents choice and preference at St Georges Lodge and the systems in place support this process. All the feedback received during the visit and via surveys was extremely complimentary and confirmed the home offers a very high standard of care. The home has clear policies and procedures in respect of residents finances. Each Care Homes for Older People Page 25 of 29 Evidence: resident is responsible for their own finances or Power of Attorney forms are agreed and signed where appropriate. The home does keep a small weekly budget for each resident for day to day sundries. The residents are required to sign when any cash is deducted. All records and receipts relating to these accounts were seen during the visit and found to be in very good order. The AQAA completed by the owner and manager prior to the visit contained comprehensive information that we were able to evidence during the visit. Clear details were given regarding how the home had improved since the last inspection, areas that it needs to improve, and the ways in which they are planning to do this. The health and safety aspects of the premises have been improved since the last inspection. Risk assessments are completed and reviewed. All relevant health and safety checks and audits are undertaken on a monthly basis as part of the Quality assurance audit. This ensures the safety and welfare of residents and staff is maintained. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 29 12(1)19 All necessary checks including POVA first checks must be in place prior to staff starting work. The service users? personal allowance as managed by the home must all be kept separately and not pooled together. 30/07/2007 2 35 20(1) 30/07/2007 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!