Care Home: St Martins Haven

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What the care home does well St Martin`s Haven is a smaller service and offers a very homely atmosphere. People were complimentary about the services provided. Individuals commented that staff are caring, friendly and that they were all "very well looked after". For what the home does well, people wrote comments like, "look after me in general" ; "everything " and "I feel at home here and comfortable". Prospective users of this service can be confident that their needs would be fully assessed prior to moving there. Care plans set out well the individual needs of each person and how staff members should meet these needs. Healthcare needs are closely monitored and the home takes prompt action to address any changing needs and seeks advice from other relevant professionals. Staff have a variety of skills and knowledge relevant to the setting and each person`s needs are well understood. Respect and dignity is maintained for each person and their individual personalities and rights are valued by the staff. The manager and staff continue to be proactive at meeting the specific social, health and personal care needs of the people who live at the home. The people living at the home have good positive relationships with staff, and get on well with each other. Staff gave positive comments about working in the home. "This home promotes independence and ensures a safe environment as well as ensuring that all staff are competent with the job that have been allocated to them." Another staff wrote, "care for service users, encourages a family team feeling." People are supported to follow their preferred interests and hobbies. The staff team make good efforts to provide interesting and stimulating activities both within the home and local community. Furnished to a good standard, people are provided with comfortable and homely surroundings. Facilities are kept clean, safe and well maintained. Good systems are in place to promote and protect the health, safety and welfare of people living and working in the home. What has improved since the last inspection? The home has improved upon the four required areas from our last inspection. Care plans were being reviewed every month to ensure that any changing needs are monitored more closely and people get the right care and support. A new IT system has been set up and is accessible to the staff. Staff have had training to use the computer so that they can maintain the necessary records about the care that people receive. In addition, policies, procedures and other guidance are available through the intranet system. A policy on the new Mental Capacity Act had been developed. Monthly reports to show that the responsible individual or appointed representative completes an audit of the service were being kept in the home. Recruitment practices have improved although some additional checks are needed as discussed in what the service could do better. What the care home could do better: Some amendments are needed in the home`s Statement of Purpose concerning the age range and type of needs that the home can accommodate. Care plans must include more information about how intended outcomes will be achieved for each assessed need to ensure that staff are aware of how people prefer to be supported and that their personal needs and goals are met. Some further information is needed concerning the management of one person`s diabetes so that staff have full details on how to ensure their welfare. Staffing rotas must be recorded in more detail so that they provide an accurate and true record of staff working in the home. On the whole staff are safelyrecruited, but the employer must make sure that full employment histories are explored and recorded. This applies to all existing and future staff working in the home. This will further ensure that people using the service are protected from unsuitable workers. Staff now need to refresh their training on diabetes so that they are up to date with best practice. We have made some good practice recommendations for the provider to consider. The home should undertake regular medication checks to maintain an audit trail and further ensure safe practice.A monthly summary of events is written up for each person so that keyworker staff can check what has been happening for the individual and to further ensure they are meeting their needs and aspirations. That training on the Mental Capacity Act and new legislation is rolled out to all staff working in the home so that they are familiar with the guidance and can apply it in their practice.The job application form for staff is revised to include a request for a FULL employment history and written explanation of any gaps. This further ensures that all people who work at the home are safe to do so. The company owners undertake all staff recruitment. We think that the home manager should have direct involvement with the selection process as this further ensures that the right staff are employed for meeting people`s needs. The names of staff and people involved in fire evacuation drills should be recorded to show that those taking part have refreshed their knowledge at regular intervals. Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Martins Haven 86 Culverley Road Catford London SE6 2JY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Claire Taylor     Date: 1 8 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: St Martins Haven 86 Culverley Road Catford London SE6 2JY 02084650020 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : jayne.bird@elizabethpeters.co.uk Elizabeth Peters Care Homes Limited care home 6 Number of places (if applicable): Under 65 Over 65 6 6 dementia mental disorder, excluding learning disability or dementia Additional conditions: 6 6 This home is registered for 6 persons with dementia or mental health problems over 50 years Date of last inspection Brief description of the care home St Martins Haven is a small care home in a quiet residential street in Catford. The service provides care for six adults with past or present mental health problems. The home is a good walk away from the town centre, although there is a parade of shops much closer. Public transport is available in the form of local buses and two train stations, both of which provide links into London. The home is one of a group of four homes run by Elizabeth Peters Care Homes Limited. The weekly fees for a place at St Martins Haven ranged from £350.00 to £550.00 and there was one vacancy at the time of this inspection. Further information about the home and services provided can be found in the Statement of Purpose and Service Users Guide. Copies can be obtained directly from the home. Care Homes for Older People Page 4 of 29 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: 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 as it appears throughout this inspection report refers to the Care Quality Commission. Prior to our visit, the home returned its Annual Quality Assurance Assessment (AQAA) when we asked for it. This is a self-assessment that must be completed once a year. It is used to tell us about the services provided, how well outcomes are being met for people using the service and any planned developments. The AQAA was brief and some details are included in this report. We spent an afternoon and evening at the home and the registered manager was available throughout the inspection. We met and spoke to the five people who live in the home and two members of staff. We case tracked two peoples records of care. Case tracking means we looked in detail at the care people receive. We also looked at various records in relation to the staff and the way the home was being run. All this information helps Care Homes for Older People Page 6 of 29 us to develop a picture of how the home is managed and understand what it is like to receive support and care at St Martins Haven. Four people living in the home completed have your say comment cards and we also received surveys from four staff. All those who contributed to the inspection process are thanked for their time and for sharing their views about the home. What the care home does well: What has improved since the last inspection? What they could do better: Some amendments are needed in the homes Statement of Purpose concerning the age range and type of needs that the home can accommodate. Care plans must include more information about how intended outcomes will be achieved for each assessed need to ensure that staff are aware of how people prefer to be supported and that their personal needs and goals are met. Some further information is needed concerning the management of one persons diabetes so that staff have full details on how to ensure their welfare. Staffing rotas must be recorded in more detail so that they provide an accurate and true record of staff working in the home. On the whole staff are safely Care Homes for Older People Page 8 of 29 recruited, but the employer must make sure that full employment histories are explored and recorded. This applies to all existing and future staff working in the home. This will further ensure that people using the service are protected from unsuitable workers. Staff now need to refresh their training on diabetes so that they are up to date with best practice. We have made some good practice recommendations for the provider to consider. The home should undertake regular medication checks to maintain an audit trail and further ensure safe practice.A monthly summary of events is written up for each person so that keyworker staff can check what has been happening for the individual and to further ensure they are meeting their needs and aspirations. That training on the Mental Capacity Act and new legislation is rolled out to all staff working in the home so that they are familiar with the guidance and can apply it in their practice.The job application form for staff is revised to include a request for a FULL employment history and written explanation of any gaps. This further ensures that all people who work at the home are safe to do so. The company owners undertake all staff recruitment. We think that the home manager should have direct involvement with the selection process as this further ensures that the right staff are employed for meeting peoples needs. The names of staff and people involved in fire evacuation drills should be recorded to show that those taking part have refreshed their knowledge at regular intervals. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall, the home provides good information about the services offered and introduction opportunities so that people can decide whether the care home can meet their support and accommodation needs. Some amendments are needed however for accuracy. Good arrangements are in place for assessing peoples needs so that staff know how to support them. Evidence: We looked at the homes Statement of Purpose which on the whole, provides people with good information about St Martins Haven. Some amendments are needed however concerning the age range and type of needs that the home can accommodate. The same five people live in the home, most of whom have done so for many years. Apart from one person, all the other people are over the age of 65 years and their older age needs must be considered in the homes stated purpose. In addition, any specific health conditions need to be included as there is one person who Care Homes for Older People Page 11 of 29 Evidence: has diabetes. There was one vacancy at the time of this inspection. We saw that each person is given a copy of the Service User Guide at the point of moving in. The guide had also been updated in September 2008 and was supplemented with pictures and photographs. Feedback from the four surveys was that each person received enough information about the home before moving there and that they each received a contract about the homes terms and conditions. We looked at three peoples files and each contained a detailed pre-admission assessment that had been carried out by the manager. The assessment is usually completed with the person, his/her relative or representative and with the relevant professionals that have been associated with the referral. Detailed information about the person, their medical and social history background and details of specific care areas such as mental health state, medication and mobility are included. We saw that keyworker staff had completed full mental health needs assessments in March and April of this year. These were written in a person centred way and each individual had signed in agreement. There were lots of useful sections to tell staff about the persons particular needs. Examples included their qualities, self concept, ways of communication, family history and psychiatric support. Each person had a recent Enhanced Care Programme Approach (CPA) on their file. This clearly detailed their needs and any presenting risk factors. There were also other reports from professionals including a psychiatric report. The contracts were clear and updated in March of this year. They contained information about fees and the obligations of the provider and person living in the home. We saw that staff had discussed these contracts with people and they had signed their contract, as had the manager of the home. The manager discussed the homes admission process and looked at the procedure. This shows that people are introduced to the service and can settle in at a level and pace appropriate to them, through visits, meals and an overnight stay. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements have meant that care plans are more person centred although more detail is needed so that peoples individual needs can be fully met. Staff treat people who live in the home with respect and maintain privacy and dignity for individuals. The homes medication systems are well organised to ensure safe, consistent treatment and support for each person. People and their families are consulted about ageing, illness and death in order that their beliefs would be observed and choices respected. Evidence: As previously required, review notes showed that peoples care needs were being reviewed monthly with amendments made where needs have changed. We saw that some progress has been made to use a more person centred approach in the delivery of care. Care records included an up to date external professional care plan (CPA) which was detailed in areas such as psychological / mental health needs, personality and preferences. These included an individual care plan summary that stated how staff are to support the person to meet their needs and help them achieve their goals. The owning company has recently developed an intranet system and staff can now use the Care Homes for Older People Page 13 of 29 Evidence: computer to write daily reports, care plans and other necessary records for meeting the needs of people who use the service. The manager showed us a copy of the new care plan format which had been completed for one person. Other care plans were brief and did not cover all areas of assessed need. Each plan needs to specify each persons individual needs and how these will each be met by the service. Once this work has been completed it will mean that people can be assured that their assessed and changing needs will be reflected in their individual plans and that staff always know the persons current needs and wishes. One example related to supporting one person to manage their diabetic condition. There were no guidelines for staff to follow concerning the management of the persons diabetes however. Further detail and a risk assessment is therefore needed so that staff have clear instruction and an agreed timescale on when to seek assistance from the emergency services. We looked at some reports which gave a good outline of a persons daily experiences, activities, their health and well being and any significant issues. Each person has a named keyworker staff to support them. As good practice, we suggest that a monthly summary of events is written up for each person so that staff can check what has been happening for the individual and to further ensure they are meeting their needs and aspirations. We saw that peoples right to privacy is respected and that they can choose when to spend time alone or with others in the house. We saw staff knock on bedroom doors before being invited in and that people have their own key to their bedrooms. All people living at the home are registered with a general practitioner and are supported to access a full range of NHS services. The input of other healthcare professionals was clearly recorded in peoples care plans. There are good systems in place for monitoring peoples physical well being. Records told us that staff seek advice promptly if they have concerns about an individuals health. This was seen in one persons notes where staff had noticed a change in their mental state and some increased confusion. Four people returned surveys to us and all ticked that they always received the care, support and medical care they need. Medication is supplied from a local chemist and records were accurate for the receipt, disposal and return of medication. The administration charts were signed and accounted for and records showed that all staff have been trained to administer medication. One person was taking responsibility for monitoring their diabetes and taking their own medication on a daily basis, having been assessed as safe and capable to do so. They had support from staff with this, and a fridge in their room for safe storage of insulin. As good practice, we think that the home should undertake regular medication checks to maintain an audit trail and further ensure safe practice. Peoples wishes in respect of what will happen in the event of their death had been obtained and recorded. Families and representatives are also involved. These were personalised well to reflect peoples individual choices for type of funeral, chosen hymn and service for example. Care Homes for Older People Page 14 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their lifestyle and on the whole, activities are offered to suit their individual needs and expectations. Visitors are welcome and people are supported to keep in touch with their families and friends. People who use the service are offered a healthy diet and enjoy their meals at times that suit them. Evidence: Records told us that individuals are consulted about their care and join in with meetings to discuss activities, food menus and any other issues to do with the way the home is run. In response to our survey question, does the home arrange activities that you can take part in if you want? all four people ticked always. Due to their older age, most people tend to prefer to stay in their home surroundings and this was reflected in each individuals care plan. Each persons preferred social interests and hobbies were clearly recorded. People were leading different lifestyles dependent on what they liked, could and/or wanted to do wherever possible. Some people are independent in leaving the home to make visits to the local community. One person said they sometimes go out for a walk in the local area. Staff ask people each day for their meal choices and keep a record of the food provided. One person likes to shop for Care Homes for Older People Page 16 of 29 Evidence: and cook their favourite Carribean food dishes and prepared their lunch during our visit. People ticked on their surveys that they always like the meals in the home. 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. People have confidence that their views will be listened to and acted upon. Arrangements for protection are managed well to ensure that people who use the service are kept safe from possible harm and poor practice. Evidence: The owning company has a clear procedure for dealing with complaints and copies are accessible to people using the service, their relatives and other parties. Information is made available in the Service User Guide about how a complaint, concern or suggestion should be made, and how this will be managed. We received a 100 response on surveys that people knew who to speak to if they were unhappy and how to make a complaint. Records confirmed that staff are properly inducted on abuse awareness and there are policies and procedures for safeguarding adults that give clear specific guidance to those using them. There was also information about relevant local authority procedures which will guide staff on who to alert in the event of a safeguarding concern. Records confirmed that the manager and one staff had refreshed training on safeguarding in June of this year. Remaining staff were booked to attend a later course in July and October. We have received no complaints or safeguarding concerns about the home since our last inspection in June 2007. In response to our previous requirement, the owning company has written a policy on the Mental Capacity Act and Deprivation of Liberty Safeguards(DOLS). This relates to new legislation which came into force in April of this year and concerns the protection of Care Homes for Older People Page 18 of 29 Evidence: peoples rights when using care services. The manager had recently completed relevant training and we suggest that other staff also attend similar training so that they are familiar with current legislation and practice. 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. People live in a clean and homely environment, which is decorated and maintained to a good standard. Bedrooms are comfortable and pleasantly decorated, reflecting peoples personal identities, and being suited to their individual needs. Evidence: The manager told us about some home improvements that have taken place since our last inspection. We looked around the premises which was clean, tidy and in a good state of repair. New wooden flooring has been fitted on the ground floor and the vacant bedroom has been redecorated and new furniture purchased. The patio area has been cleaned and a new widescreen television bought for the lounge. For how the home has improved over the last twelve months, the AQAA said, staff have been trained in infection control and this has been put into practice. Some of the bedrooms were viewed with peoples permission. They were comfortably furnished and decorated to a good standard. People have personalised their rooms as they so choose with family photographs and other meaningful possessions. Four people using the service ticked on their surveys that the home was always fresh and clean. There is a lounge and bright spacious dining area in an extended part of the building. Both communal areas are furnished with comfortable furniture and decor. The home appeared very clean and tidy and people are encouraged supported to join in with housekeeping tasks and the upkeep of their rooms. In one bathroom, a hoist was available for people who Care Homes for Older People Page 20 of 29 Evidence: have mobility needs. The manager advised that although none of the current people living in the home needed it, the home has kept it for possible future use. We saw that the hoist had been serviced at regular intervals. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a stable staff team who have a range of skills and experience to meet their needs.There are good recruitment practices which safeguard people from unsuitable staff although some additional checks are needed to ensure that people are fully protected. Evidence: People benefit from a stable team, most of who have worked at St Martins Haven for many years. People we spoke to also expressed a confidence in the staff team. Staff on duty were respectful and supportive to individuals. There is a low turn over of staff, and people benefit from the consistency of a well-established staff team. We looked at a selection of rotas which showed that staffing levels remain at 2 per shift with one staff on a sleep in duty at night. Some improvements are needed with the rotas however as they did not provide an accurate record of who worked. Rotas did not include the the full names and roles of the staff or who was in charge. This must be addressed for better clarity and legal purposes. Regular staff team meetings are held; minutes were clear and focused on peoples needs as well as the day-to-day running of the home. On surveys, four people ticked that staff are always available when they need them and that staff always listen and act on what they say. We looked at two staff files which included the most recent employee. These contained most of the required legal checks and documentation which shows that the home takes care to Care Homes for Older People Page 22 of 29 Evidence: recruit staff correctly. Two references were on each file, a completed CRB check, health declaration, proof of identity and records of interview notes. For each staff however, there were some gaps in their employment histories with no written explanation. Full recruitment checks must be carried out on all employees to ensure that people are fully protected and any gaps in employment must be explored and recorded. We further suggest that the homes job application form be revised to request any future employees full employment history and not the previous ten years. The manager advised that all staff recruitment is carried out by the company owners. We think that the home manager should take part in any future staff recruitment so that they can have direct involvement with the selection process and help ensure that the right staff are employed for meeting peoples needs. Staff gave positive responses on their surveys. Four staff replied that they were given training relevant to their role and that there were always enough staff to meet the individual needs of the people using the service. A training plan was in place showing which staff had undertaken training and which training was planned or booked for the next year. Most staff had attended courses on medication, infection control, manual handling, fire safety, protection of vulnerable adults, food hygiene and health and safety. Some staff had undertaken training in specific topics such as mental health in later life and the mental capacity act. Given that one person has diabetes, staff must now refresh their training so that they are up to date with best practice and current developments. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from a well managed home. The home has adequate quality assurance and quality monitoring systems designed to monitor, review and develop the service. Good safe working practices ensure that the home aims to promote and protect the health and welfare of people at all times. Evidence: The registered manager Jayne Bird has worked in the home for many years and continues to demonstrate effective management practice. Discussions and observation confirmed that the manager is knowledgeable about each persons unique needs and understands the importance of person centred care and improving outcomes for people. The manager had kept her training updated and recent courses included the Mental Capacity Act and Deprivation of Liberty Safeguards as well as safeguarding vulnerable adults, food safety, fire awareness, first aid and mental health in later life. We saw various systems for monitoring the quality of the service. People living in the home and their relatives were offered satisfaction questionnaires in May of this year. Care Homes for Older People Page 24 of 29 Evidence: The manager expalined that she did not receive any surveys from the relatives on this occasion. Feedback from people was very positive with all responses ticked as happy. A responsible individual from the owning company visits the home once a month and completes an audit of the service. Reports were detailed and showed that the owners make sure the conduct of the home is closely monitored and action is taken to make improvements when needed. The previous requirement has therefore been met concerning this issue. We also saw an annual development plan, which forms part of, and is linked to, the quality assurance and monitoring systems. The plan provides a way in which the service is able to identify areas of strength and weakness, create an action plan and monitor improvements based upon feedback from consultation or auditing processes. Staff spoke well of the manager and felt supported in their work. Survey responses from the four staff who returned them said that they regularly met with their manager. Records supported this; that staff receive regular supervision as well as an annual appraisal of their work. These systems therefore support staff to do their jobs well and reflect upon their performance and practice. We saw that there were several processes to ensure safe working practices. There was a health and safety folder with relevant policy guidance available to staff to follow and underpin their working practice. The general risk assessments had been updated in January 2009. Each one reflected any hazards and best actions to reduce the risk of harm and ensure the safety and well being of all those living and working in the home. Examples included fire, use of the kitchen and garden, smoking in bedrooms and hot radiators. Lewisham local authority undertook a health and safety inspection of the premises in May of this year and no issues were raised. The completed AQAA stated that all relevant safety checks were up-to-date. We confirmed this when we checked the servicing and maintenance records including gas and electrical safety. Fire drills, fire equipment and hot water temperature checks were being carried out at regular intervals. To show that people refresh their knowledge of fire evacuation procedures, it would be better if the names of all people taking part in a drill were recorded. This will further ensure that those taking part have refreshed their knowledge at regular intervals. A new IT system has been set up and is accessible to the staff. Staff have had training to use the computer so that they can maintain the necessary records about the care that people receive. In addition, policies, procedures and other guidance are available to them through the homes intranet system. Any accidents or incidents involving people living in the home and/ or staff were fully completed. As good practice we think that information about reporting events under Regulation 37 could be kept in a folder so that it is readily available to staff. Care Homes for Older People Page 25 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 26 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 1 1 4 The Statement of Purpose needs updating for accuracy concerning the age range and type of needs accommodated. So that people who use the service have up to date and correct information about the home and the services avavilable to them. 30/09/2009 2 7 15 Care plans must include 30/09/2009 more information about how intended outcomes will be achieved for each assessed need. This is to ensure that staff are aware of how people prefer to be supported and that their personal needs and goals are met. 3 9 13 To further ensure peoples 30/09/2009 safety and welfare, some further detail is needed concerning the management of their diabetes. Care Homes for Older People Page 27 of 29 This is so that staff have clear instruction and an agreed timescale on when to seek assistance from the emergency services 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 7 A monthly summary of events is written up for each person so that keyworker staff can check what has been happening for the individual and to further ensure they are meeting their needs and aspirations. The home should undertake regular medication checks to maintain an audit trail and further ensure safe practice. That training on the Mental Capacity Act and new legislation is rolled out to all staff working in the home so that they are familiar with the guidance and can apply it in their practice. The names of staff and people involved in fire evacuation drills should be recorded. This will further ensure that those taking part have refreshed their knowledge at regular intervals. Information about reporting events under Regulation 37 could be kept in a folder so that it is readily available to staff. 2 3 9 18 4 38 5 38 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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