Care Home: St Martins

Similar services:

• Henry Nihill House
• Birchwood
• The Infirmary
• Orchard House Nursing Home
• St Josephs Rest Home
• Red Court Nursing Home
• Spinney (The)
• Queen Elizabeth House

What the care home does well Provides good stable long-term care for service users, which is achieved through having stable and experienced management and a dedicated staff team. Support service users to maintain their family and friends` networks and to pursue their religious affiliations. Works with service users to celebrate meaningful events in their lives, involving relatives in this process. Maintains sound professional relations with external professionals to ensure that service users get good healthcare support from the community resources. Encourages service users to take exercise their autonomy, choice and control in leading fulfilled lives. Provides a safe and homely environment, which is geared towards service users` comfort. What has improved since the last inspection? The statement of purpose and service user guide have been updated for the benefit of service users. Staff had more appropriate training, which enabled them to make more appropriate action in meeting the specialist needs of service users. The activities were reviewed with service users and a wider range provided, in line with their interests. Activities were also were better advertised, resulting in increased service user participation. Initial assessments and risk assessments were of a higher quality. An occupational therapist assessment was carried out of the premises to determine its suitability for the service user group. A better system is now in place, for consulting service users about their nutritional requirements, which included a nutritional screening assessment. Staff were provided with increased safeguarding training, which ensured that safeguarding protocols were adhered to. A number of environmental improvements were made to make the home safer for both elderly and Dementia suffers. There has also been replacements and upgrades in the facilities and equipment used in the home. More robust checks have been carried out in recruitment to ensure that service users were better safeguarded. The registered manager has completed her NVQ Level 4 in Care and a wider range of specialist training has been provided for all layers of staff to improve their competency and the quality of services delivered. Food storage has improved in the home. An annual audit of the service was in process as was the annual development plan for the home. The home acquired approval from the Commission in 2007 to provide services to individuals with a diagnosis of Dementia. What the care home could do better: Explore with appropriate agencies the types of activities that could be used to engage service users with Dementia. Complete the annual audit and, the annual development plan for the service reviewing them both - annually. Key inspection report Care homes for older people Name: Address: St Martins 80 Aldersbrook Road Manor Park London E12 5DH     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: Stanley Phipps     Date: 1 7 1 2 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) © 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 27 Information about the care home Name of care home: Address: St Martins 80 Aldersbrook Road Manor Park London E12 5DH 02085305972 02085308051 bridget869@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Patrick Bell,Mrs Bridget Bell Name of registered manager (if applicable) Type of registration: Number of places registered: care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: No person with Dementia will share a room. In the event St. Martin`s has a referral of exceptional circumstances of two persons - relatives or a particular close friendship wishing to share a room, and taking into account the Mental Capacity Act 2005, the Registered Person will have to apply to the Commission for a specific minor variation. The maximum number of service users who can be accommodated is: 36 The Registered Person may provide the following categories of service only: Care home only - Code 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 - Code OP Dementia - Code DE Date of last inspection 36 0 Over 65 0 36 Care Homes for Older People Page 4 of 27 Brief description of the care home St Martins Rest Home is a registered care establishment accommodating up to thirtysix(36) elderly service users. The home could now provide care to service users suffering with a diagnosis of Dementia. It is located close to local facilities and is easily accessed by local transport. Mr Patrick Bell and Mrs Bridget Bell privately own and run the service, with Mrs Bell as the registered manager. The home is set on large grounds and itself is spread over two floors, almost in the shape of an `H. There is a large garden located between the front and the rear buildings. There are five lounging areas in the home, four on the ground floor and one on the first floor to the rear aspect of the building. Service users have access to two dining areas, one of which is smaller and cosier. A small sitting area is integrated with the latter, for individuals wishing to sit quietly. Service users are able to take their own furniture into the home, provided that it meets fire safety standards. There are a number of toilets and bathrooms on both floors that are accessible to service users. Up to sixteen bedrooms have en-suite toilets and there is also a shower room in St Martins Rest Home. Staff are on hand twenty-four hours to provide care and support to all service users to ensure that they enjoy life to its fullest potential. An emergency call alarm system is available for the benefit of service users requiring the assistance of staff. Fees are charged at £450.00 per week and service hairdressing at £15.00 per session and private chiropody charge at £22.00 per session. Service users also pay for personal effects, the prices of which are variable. The homes statement of purpose is made available to service users on request and a copy is kept in the staff office. Each service user is offered a copy of the homes service user guide, once admitted to the home. Care Homes for Older People Page 5 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: We carried out a key inspection of the service that included an unannounced site visit on the 17/12/09. During the visit, interviews and discussions were held with the registered manager and her deputy, senior and junior staff as well as service users and visiting relatives. We also undertook a tour of the building during which an assessment was made of the facilities and the overall condition of the environment. We assessed a number of records required by regulations to include: service user plans and assessments, staffing files, menus, activities plans, the complaints record, policies and procedures, medication charts, training records, accident/incident documentation, and health and safety records. In compiling this report we also considered Regulation 37 notifications submitted by the home, the findings of an annual service review carried out in February 2008 and comments made by placement authorities. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? The statement of purpose and service user guide have been updated for the benefit of service users. Staff had more appropriate training, which enabled them to make more appropriate action in meeting the specialist needs of service users. The activities were reviewed with service users and a wider range provided, in line with their interests. Activities were also were better advertised, resulting in increased service user participation. Initial assessments and risk assessments were of a higher quality. An occupational therapist assessment was carried out of the premises to determine its suitability for the service user group. A better system is now in place, for consulting service users about their nutritional requirements, which included a nutritional screening assessment. Staff were provided with increased safeguarding training, which ensured that safeguarding protocols were adhered to. A number of environmental improvements were made to make the home safer for both elderly and Dementia suffers. There has also been replacements and upgrades in the facilities and equipment used in the home. More robust checks have been carried out in recruitment to ensure that service users were better safeguarded. The registered manager has completed her NVQ Level 4 in Care and a wider range of Care Homes for Older People Page 7 of 27 specialist training has been provided for all layers of staff to improve their competency and the quality of services delivered. Food storage has improved in the home. An annual audit of the service was in process as was the annual development plan for the home. The home acquired approval from the Commission in 2007 to provide services to individuals with a diagnosis of Dementia. 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 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. Service users have access to information that enables them to make a decision to live at St. Martins. They benefit from having a thorough assessment with and for them prior to being admitted. Intermediate care is not provided in the home. Evidence: The service user guide and statement of purpose had been reviewed as required by the last inspection so that service users were able to more easily read the documents. The statement of purpose is made available prior to an admission so that prospective service users and their relatives could decide whether the home is suitable for meeting their needs. The service user guide is usually given to them once they have agreed that the home is best suited to them. Two of the most recently admitted service users felt that the information provided in both documents was useful. Care Homes for Older People Page 10 of 27 Evidence: In assessing the admission details of two of the most recently admitted individuals, detailed assessments were carried out in both cases. In so doing information from the placement authorities was obtained so that as full a picture could be gathered on each of the individuals. The assessments covered all aspects of personal, social, religious and cultural needs, which was then used to formulate a care plan. It is on this basis that the care was delivered. The assessments were carried out by the manager or her deputy both of whom were qualified to so do. The process involved the service users and their relatives and was effective in determining whether the home was able to meet their needs. St Martins do not offer intermediate care and the registered manager was aware that she would have to review both the physical and operational resources should she wish to provide this type of service. 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. Service users health, personal and social care needs are set out in their individual plans, and provide staff with the information they need to identify and meet their needs. Good evidence was available to indicate that the health care needs are wellprovided for including the support provided with the medication. Service users and their relatives were quite pleased with the way in which the principles of privacy, dignity and respect are put into practice in delivering the service at St Martins. Evidence: From the two care plans seen there was evidence that the personal, health and social care needs of the individuals were addressed based on the assessments carried out on them. It was also noted that more attention was placed on covering the religious and cultural beliefs of service users to ensure that staff were more aware as to the diverse needs of each service user. Relatives were given the opportunity to contribute to the care plan and in one of the cases viewed, this was taken up. The care plans were reviewed on average monthly or when there was a change in needs. Service users likes and dislikes were recorded and this ensured that the care provided was more individual. The overall quality of the care plans had improved and staff were using Care Homes for Older People Page 12 of 27 Evidence: them when delivering the service. Despite the varying health care needs of the service user group, staff in the home worked well to ensure that their health and welfare was promoted. All service users were registered with a GP and staff were proactive in identifying changes in service users conditions and making referrals as appropriate. In this respect appropriate contact was made with the district nurse, the diabetic nurse, the dentist, chiropodist and physio-therapist as necessary. A good record was held of all appointments attended by residents. It was noted that in October 2009, all service users had their flu jab from the GP to ensure that they were prepared for the winter season. Service users were subjected to a nutritional assessment to ensure that their dietary needs were provided for. They also had the benefit of light exercises as a way of keeping healthy. Good support was also provided with medication to enable service users to promote their health and well being. At the time of the visit all service users were receiving support with their medication. All staff with this responsibility had appropriate medication training to ensure that they were prepared for this role. An updated medication policy was in place and staff spoken to were aware of it. A brief observation of staff administering medication indicated that they carried out this function in a safe manner. The storage and acquisition of medication in the home was good and a good system was also in place for the disposal of drugs. There was no cause for concern with how medication was handled in the home and from discussions held with service users and their relatives, they were quite happy with the support provided in this respect. Medication is monitored internally by the manager and her deputy. During the course of the inspection staff were observed interacting with service users in different situations for example; support with personal care, meals, drinks, activities and helping them to go to bed. In all cases they were observed working in a sensitive and respectful manner with the service users, who were addressed by their preferred names. Staff were also observed knocking on doors and ensuring that service users were comfortable during their engagement with them. It was noted that all staff had an induction during which the values of dignity and respect were emphasised upon. Feedback from relatives and service users commented positively on how staff maintained the dignity and respect in the execution of their duties. 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. There have been some improvements in the delivery of activities in the home, which brought added enjoyment to service users. They were well-supported to maintain their family networks and benefit from being able to exercise choice and control in their lives. At St Martins meals provided were reflective of service users choice, taste, culture and nutritional requirements. Evidence: Service users were able to engage in a wider range of activities as the registered manager consulted with them more widely in this area. There is a strong emphasis on social and group activities and to this end the home now has a Karaoke machine and a Wii. Service users reportedly enjoy playing bowling and tennis on the latter of the two and photographic evidence was available of the various events held by the home. Birthdays, seasonal and religious events such as St. Patricks Day and Easter were celebrated in line with service users choice and interests. One service user spoke of his enjoyment watching sports on a choice of wide screen televisions. Staff were observed spending time with service users who preferred more personal attention either wanting a chat or talking about their pastimes. Arrangements remained in place for service users to pursue their spiritual affiliations, Care Homes for Older People Page 14 of 27 Evidence: and for many they looked forward to this. There was good evidence to support the fact that activities were better advertised and that relatives were given the opportunity to enjoy being part of the celebrations. There was evidence that some service users have the experience of going out shopping, to the cinema, restaurants and plans were in place to increase external activities in line with service users wishes. Activities for dementia sufferers were still being developed. However, there is dedicated communal space in the home where they could enjoy calmness and serenity when they need it. The registered manager may wish to consult specialist agencies, for example the Alzheimers Society or the Age Exchange Reminiscence Centre in Blackheath, South London for more ideas in relation to specific activities for dementia sufferers. Although this area is developing, relatives and service users spoken to were pleased with the quality and frequency of stimulation that was provided by the home. The home has a visiting policy which is fairly relaxed and on the day of the visit, this was evident. One service user commented that he had been in the home for quite a long time and he is able to meet up with his friend from way back when he used to be at the market. Another stated; my children and husband visits me regularly and I look forward to seeing them. Most service users spoken to welcomed the fact that their loved ones and friends could come round and see them. The Christmas party held on the 12/12/09 was an event where relatives and friends got together and from the photos, they were having a good time. In some cases service users relatives took them out as part of the spending quality time with them. Service users were therefore supported to maintain their family and friends networks at St Martins. Most of the service users gain support with their finances from their relatives. This is usually determined during their initial assessment prior to admission and is kept under review. They also have access to advocacy services should this be required, which could be accessed through an agency like Age Concern. Service users are encouraged to make choices in a most aspects of their lives for example, what they eat and wear, the times they go to bed and get up, the type of activities they engage in, and the products they use for their personal grooming. It was noted that relatives were also consulted in this respect and there was good evidence to confirm that service users were encouraged to bring in their personal possessions that they cherished and valued. A policy was in place to ensure that service users have access to their personal records. From speaking with service users, their relatives and assessing the menus and care plans, there was evidence that the nutritional requirements of service users were wellprovided for. Service users were encouraged to choose their menus, which included vegetarian, cultural and specialist diets, for example, meals that were suitable for Care Homes for Older People Page 15 of 27 Evidence: diabetics. Food was also offered in a range of forms such as soft and pureed diets where appropriate. The evening meal was observed and this appeared wholesome, nutritious, appetising and in quantities that were suited to each individual. This is particularly useful for Dementia sufferers who may benefit from smaller portions and/or finger foods. Staff supported service users in a sensitive manner and the whole experience and mealtimes was relaxed. It was noted that mealtimes were flexible both in terms of when and where service users ate. Hot and cold drinks including fresh juices were available to all service users. Care Homes for Older People Page 16 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. The manager and staff make every effort to resolve concerns and complaints as they arise in the home. As a result, service users and their relatives feel assured that when complaints are raised, they would be taken seriously. Now that safeguarding training has been provided for most of the staff team, service users enjoy a greater sense of protection from the risk of coming into harm and/or abuse. Evidence: The home has a written complaints policy and procedure for dealing with complaints, and staff spoken to were aware of the protocols around complaints, including how to deal with complaints and concerns made to them. The complaints log was inspected and indicated; complaints received, details of investigation, action taken for resolution and the outcome for the complainant. The registered persons have acted in line with their guidelines of investigating and responding to complaints within a twenty-eight day period. Feedback from service users and their relatives indicated that they knew how and who to complain to. Service users and their relatives commented that they felt assured that when they raise complaints and/or concerns - that they would be dealt with in a manner that would not deter them from thinking about raising a concern in the future. From the complaints log five complaints were noted since the last inspection as opposed to a very large number of compliments about the services provided by St. Martins. The registered manager informed that she uses complaints as a way of improving the service, which is positive. Care Homes for Older People Page 17 of 27 Evidence: An updated safeguarding policy was in place and available to all staff. Discussions and interviews held with staff indicated that they had a good understanding about their role in safeguarding vulnerable adults. This was supported by the fact that most apart from the newly recruited staff had updated safeguarding training. Since the last inspection there has been no further safeguarding issues as the registered manager took the required actions to ensure better safeguards for people using its services. It should be noted that the recruitment practices were now more robust and this served an integral part of safeguarding, as staff were thoroughly screened before being offered a job at St. Martins. Care Homes for Older People Page 18 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. Service users enjoy living in a home that is welcoming, clean, comfortable and generally designed to meet their needs. Improvements in maintenance, along with good hygienic practices ensure that service users live in a safe environment at St. Martins. Evidence: On the day of the visit the home was clean, tidy, airy and free from offensive odours. The external grounds were well-maintained and service users were observed making their way around the ground floor of the home comfortably. Most of the day to day maintenance is carried out by the registered provider who is at the home on a regular basis and so the home was well-maintained. There were several improvements to the physical environment which included: a new front door, which was more secure, a walk-in shower on the ground floor and repairs to the defective handrail on the ground floor. Improved signage was in now place to enable people with Dementia to keep in tune with both their personal and communal spaces including bathrooms and toilets. An occupational therapist assessment was carried out on the building and the manager provided evidence to demonstrate compliance with the local fire and environmental departments. There was evidence of improvements to the lighting in the home with the purchase of new chandeliers, new armchairs as well as a new cooker. It was positive to see that developments were carried out on the home to Care Homes for Older People Page 19 of 27 Evidence: improve the safety and comfort of service users living there. Discussions held with service users and their relatives indicated that they enjoyed living at St. Martins and that it was a friendly and comfortable place to be. The laundry area was inspected and this was found to be clean, with soiled articles, including clothing and bed-linen being appropriately stored - pending washing. Staff working in the laundry were aware of health and safety measures including infection control, and the handling and storage of chemicals. The laundry floor covering was suitable and the facility is cited well away from the kitchen. Service users and their relatives were complimentary about the quality of the laundry services and both, were happy that their personal clothing were always returned. It was clear that all aspects of the home internal and external were well-maintained in that it was safe, clean and hygienic. The home complies with the Water Supply Regulations 1999 and as such, St. Martins generally remains fit for its purpose in providing care and support to elderly service users. Care Homes for Older People Page 20 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. Service users have the benefit of receiving care and support from a staff team that is sufficient in numbers, has a good balance of skills, and training to meet their needs. The robust recruitment practices undertaken by the registered manager provide good safeguards for people living in the home. Evidence: On the day of the visit, the staffing numbers were sufficient to meet the needs of the service users. The inspector examined the staffing rota, which clearly evidenced how staff were deployed on a daily basis. There was good cover on all three shifts and the staffing numbers reflected changes in service users needs to include an increase in activities carried out on a daily basis. Feedback received from service users and their relatives about the staffing included; staff are always on hand when you need them, it is very comforting to know that they are here to help you and they are always ready to help and encourage you. It should be noted that overall, there has been a continuous decline in falls in the home, despite the fact that service users were getting older, more frail and generally living longer. The registered manager demonstrated an understanding for the need to keep her staffing levels under review in order to safely meet the changing needs of service users. It was noted that service users benefited from having a staff team, that has been fairly consistent in its make up in that a core group of staff have been retained to Care Homes for Older People Page 21 of 27 Evidence: work in the home. There were low levels of sick leave and the staff turnover was relatively low. Covering staffing absence was done mainly from the core group of staff to ensure both stability and consistency, as most of the service users relished the idea of seeing a familiar face. It was noted that up to eighty per cent of the staff had achieved at least their NVQ Level 2 in Care. At least one of the senior staff did complete Level 3 with the deputy manager and another senior starting Level 4. There was a clear commitment to improving the qualifications and skills of staff with a view to providing an improved service at St. Martins. The recruitment files of two of the most recently appointed staff were examined and found to be in order. Necessary checks such as Criminal Records Bureau (CRB) checks, Safeguarding of Vulnerable Adults First checks, and the required minimum of two satisfactory references were all in place. Completed application forms were on file as well interview notes, health care declarations and valid identification checks. The registered manager also took on board, checking the eligibility of staff to work in the United Kingdom. All staff have access to the General Social Care Councils code of conduct and so has a good basic understanding of the principles of delivering safe and effective care. The procedures for the recruitment of staff were robust and provide safeguards for people living in the home, which is positive. All staff spoken to were in receipt of a statement of their terms and conditions. Since the last inspection, there has been an improvement in the depth and range of staff training across the board. It was noted that the training was geared towards meeting the specialist needs of service users covering areas like: Dementia, Mental health Awareness, Infection Control, Diabetes, Oral hygiene, Safeguarding Vulnerable Adults, Food Hygiene, Equality and Diversity, First Aid, Medication, Risk Assessments and Understanding the Mental Capacity Act 2005. In addition, all staff had the benefit of induction training in line with the Skills for Care Common Induction Standards. More recently the registered manager completed End of Life training and planned to send staff on a similar course to ensure that end of life care could be better provided at St. Martins. The inspector was satisfied that appropriate steps were taken to ensure that the staffing competence was enhanced through training that was in line with service users needs. Care Homes for Older People Page 22 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. Service users are assured that the home is managed and run by an individual who is qualified and fit to so do. There were quality assurance mechanisms to ensure that the service is reviewed and developed, although some needed fuller implementation. Good financial, and improved health and safety practices promote and protect the health, safety and welfare of staff and service users alike. Evidence: The registered manager has managed the home for over twenty-four years and has a good understanding of the needs of the service users group. She has completed her NVQ Level 4 in Management and is now pursuing her Registered Managers Award. She has undertaken training to update her skills and knowledge in providing services for the elderly in areas such as; Dementia and End-of-Life Care. She has the support of a deputy manager who is also quite experienced, qualified and knowledgeable in the provision of elderly care. Mrs Bell leads from the front and has strong and positive relationships with her staff, relatives, service users and external professionals. Feedback received from service users and their relatives has been very positive about Care Homes for Older People Page 23 of 27 Evidence: how the home is run. There was evidence that quality assurance and monitoring systems were in place for the service, although there was room for this to be improved on an annual basis. Service users surveys were carried out and feedback from their annual reviews feed into the homes quality assurance processes. The registered manager reported that service users views are also captured in their service user meetings which were held on a four to six weekly basis. The annual audit for the service had started as was the annual development plan for the home, which should be completed. Staff contribute to the service development through their supervisions and team meetings. Policies and procedures were found updated and available to staff at the time of the visit. Service users therefore benefit from a service that is geared up to reviewing the quality of its service provision. The quality review would be enhanced with the completion of the annual audit and the annual development plan. Systems were in place for managing service users finances, most of which was handled by their relatives and/or representatives. This is monitored by the registered manager who ensures that transactions carried out with and for service users were done in line with policy guidelines. A random sample of up to three service users personal and financial records was assessed during the course of the inspection. They were all found to be in order. Secure facilities were in place for the safekeeping of service users money and valuables. It was conclusive that service users finances were safeguarded at the home, as sound protocols were in place to ensure that this happens. There have been no incidents recorded or reported of financial impropriety in the home. A wide range of records were looked at including; fire safety, emergency lighting, lift and wheelchair maintenance/service, gas and electrical certificates, accident and incident reports, fridge/freezer temperature recording, and portable appliance testing records. They were found updated and in good order including Legionella tests that were carried out. Safety signs were appropriately posted throughout the home and all staff had mandatory health and safety training. Risk assessments were also in place for all safe working practices, and health and safety policies were updated and accessible to all staff. The storage of food in the home was assessed and found to be of a good standard. As such, service users and staff can feel assured that good health and safety management, including risk control measures for risks identified, were in place at St. Martins to ensure that the home remains fit and safe for its purpose. 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 1 12 The registered manager should explore opportunities to develop specialist activities for the benefit of Dementia sufferers. The registered manager should complete the annual audit, and annual development plan for the home to ensure that service users fully benefit from their contributions provided to developing the service. 2 33 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. © 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. 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!