Care Home: St Oswalds House Nursing Home

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well People`s needs are assessed before they go to live at St Oswald`s to make sure that the home will be able to provide the care they need. Each resident has a care plan and some of the care plans we looked at had been very well written to reflect the needs and preferences of the individual. All of the care plans recorded regular reviews and residents and their relatives are invited to attend a full review of the care every three or six months, depending on the person`s health. A relative we spoke with was very positive about the care her mother receives and confirmed that she has three monthly reviews of the care plan with the nurses. Medicines are well managed, storage and recording is good and indicates that people always receive what has been prescribed by their doctor. An activities organiser is employed for 30 hours a week and notice boards show a lot of activities going on. A resident told us that the activities organiser is great. There is a structured activity programme that includes one to one and group activities to meet all the needs of the individuals. There is a relatives` noticeboard in the entrance area that gives details of forthcoming events. Friends and relatives are made welcome and a comment we had from a staff questionnaire was `The home makes all visitors welcome and residents also. We try to make St Oswald`s home from home. We at St Oswald`s like to be friendly and are always ready for anyone to offer advice on ways of helping residents to settle in and remain happy.` All of the staff who completed a questionnaire replied that they would know what to do if a resident or their relative expresses a concerns, and the training records showed that in the last year 89% of the staff have done training about abuse. The home manager is a certified Action on Elder Abuse trainer. When we visited, the home was clean, tidy and free from unpleasant odours. The laundry was well-organised. An environmental health officer visited on 20/7/09 and gave the kitchen a five star rating. Good recruitment procedures were followed for new staff to make sure that they would be safe to work with vulnerable people. Training records are well maintained and showed that new staff receive induction training and established staff have regular updates of their training. A new manager started working at St Oswald`s in December 2008. She has over 20 years experience in working with older people. She is a first level registered nurse and has the Registered Managers Award among other qualifications relevant to the role. The deputy manager is not a nurse but is a very experienced carer and has worked at St Oswald`s for a long time. She has worked under several managers but said the current manager is `brilliant`. Southern Cross Healthcare has a comprehensive home audit that covers all aspects of the service. This is completed monthly by the manager and deputy, and in alternate months by the operations manager. Medicines and accident reports are checked monthly, and a random sample of care plans. Regular staff meetings and residents meetings are held so people have the opportunity to express their views. Care staff have a regular supervision meeting with the deputy manager. The maintenance person keeps a file that records the regular safety checks he carries out: this includes a weekly checks of hot water temperatures, wheelchairs, bedrails and fire doors. Emergency lighting is tested monthly and fire drills are held approximately monthly. The overall standard of record keeping is very good. What has improved since the last inspection? No requirements were made following our last inspection of the home. The manager has improved the organisation in the kitchen. She brought in a cook from another home who has a good record in cleanliness and standard of food to give advice to the staff at St Oswald`s. New menus and home baking have been introduced. A relative told us that the quality of meals has improved. The old part of the building has been much improved with decorating and refurbishment and new doors have made it lighter. The dining room has been refurbished and is very pleasant, although not big enough to accommodate everyone. The tables were nicely laid for lunch and there was a menu on each table. What the care home could do better: Some of the daily reports in the care plans were not detailed enough and did not give any information about how the person had been feeling or what they had done. Some of the care plan reviews also lacked any meaningful content. The conservatory is out of use waiting repair. This has reduced the amount of day space available and needs to be fixed without delay. Some of the double glazed window panes have `blown` and are full of condensation. They need replacing so that people can look out properly. There were trolleys containing clean linen in two of the bathrooms. This is not good practice and the manager needs to make better arrangements for storage. The manager has not yet applied to be registered with the Commission and must do this without further delay. Key inspection report Care homes for older people Name: Address: St Oswalds House Nursing Home 12 Golborne Road Winwick Warrington Cheshire WA2 8SZ     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: Wendy Smith     Date: 2 2 0 7 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 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: St Oswalds House Nursing Home 12 Golborne Road Winwick Warrington Cheshire WA2 8SZ 01925656337 01925573113 stoswalds@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Southern Cross Healthcare (Cheshire) Limited care home 42 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home with nursing: Code N, to people of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP The maximum number of people who can be accommodated is 42 Date of last inspection Brief description of the care home St Oswalds House is a care home providing personal care and nursing care for up to 42 older people. The home was first registered in 1987 and consists of a two-storey Victorian building and a single storey extension. It is set in its own grounds in the Winwick area of Warrington. 0 Over 65 42 Care Homes for Older People Page 4 of 25 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: The quality rating for this service is two stars. This means that the people who use this service experience good quality outcomes. Two inspectors visited St Oswalds unannounced on 22 July 2009 as part of this inspection. During the visit we spoke with residents, staff and visitors. We walked round the building to see all the communal areas and some of the bedrooms. We checked some of the records kept at the home and spent time talking with the manager. We also looked at any information that we had received about St Oswalds since our last inspection there. Before the inspection the manager was asked to complete a questionnaire to give us up to date information about the service and survey forms were sent out for staff to give us their views. Care Homes for Older People Page 5 of 25 What the care home does well: Peoples needs are assessed before they go to live at St Oswalds to make sure that the home will be able to provide the care they need. Each resident has a care plan and some of the care plans we looked at had been very well written to reflect the needs and preferences of the individual. All of the care plans recorded regular reviews and residents and their relatives are invited to attend a full review of the care every three or six months, depending on the persons health. A relative we spoke with was very positive about the care her mother receives and confirmed that she has three monthly reviews of the care plan with the nurses. Medicines are well managed, storage and recording is good and indicates that people always receive what has been prescribed by their doctor. An activities organiser is employed for 30 hours a week and notice boards show a lot of activities going on. A resident told us that the activities organiser is great. There is a structured activity programme that includes one to one and group activities to meet all the needs of the individuals. There is a relatives noticeboard in the entrance area that gives details of forthcoming events. Friends and relatives are made welcome and a comment we had from a staff questionnaire was The home makes all visitors welcome and residents also. We try to make St Oswalds home from home. We at St Oswalds like to be friendly and are always ready for anyone to offer advice on ways of helping residents to settle in and remain happy. All of the staff who completed a questionnaire replied that they would know what to do if a resident or their relative expresses a concerns, and the training records showed that in the last year 89 of the staff have done training about abuse. The home manager is a certified Action on Elder Abuse trainer. When we visited, the home was clean, tidy and free from unpleasant odours. The laundry was well-organised. An environmental health officer visited on 20/7/09 and gave the kitchen a five star rating. Good recruitment procedures were followed for new staff to make sure that they would be safe to work with vulnerable people. Training records are well maintained and showed that new staff receive induction training and established staff have regular updates of their training. A new manager started working at St Oswalds in December 2008. She has over 20 years experience in working with older people. She is a first level registered nurse and has the Registered Managers Award among other qualifications relevant to the role. The deputy manager is not a nurse but is a very experienced carer and has worked at St Oswalds for a long time. She has worked under several managers but said the current manager is brilliant. Southern Cross Healthcare has a comprehensive home audit that covers all aspects of the service. This is completed monthly by the manager and deputy, and in alternate Care Homes for Older People Page 6 of 25 months by the operations manager. Medicines and accident reports are checked monthly, and a random sample of care plans. Regular staff meetings and residents meetings are held so people have the opportunity to express their views. Care staff have a regular supervision meeting with the deputy manager. The maintenance person keeps a file that records the regular safety checks he carries out: this includes a weekly checks of hot water temperatures, wheelchairs, bedrails and fire doors. Emergency lighting is tested monthly and fire drills are held approximately monthly. The overall standard of record keeping is very good. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 7 of 25 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 25 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 25 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. Peoples needs are assessed before they go to live at St Oswalds to make sure that the home will be able to provide the care they need. Evidence: On the day we visited St Oswalds 38 older people were living there; 26 people were receiving nursing care and 12 receiving personal care. In the self-assessment the manager told us that people interested in going to live at the home are actively encouraged to visit the home themselves, for a meal or to join in a planned activity to give them a taste of life at St Oswalds. Before someone new comes to live at the home, either the deputy manager or one of the nurses goes to visit them and assess their needs. We spoke with the deputy manager about this and she told us that staff at the local hospital are not always very helpful in providing information. We looked at the care notes for two people who came to live at St Oswalds quite recently and they both had full assessments provided by Care Homes for Older People Page 10 of 25 Evidence: their social worker before they moved in. From the information gathered, a preadmission draft care plan was produced. This gives the staff guidance about what care and support the person will need when they first arrive until a more in-depth assessment is completed. Care Homes for Older People Page 11 of 25 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. The health and personal care needs of the people living at the home are met and their medicines are managed safely. Evidence: Each resident has a care plan that includes assessments of their needs and risk assessments for any identified risks. From the assessments, plans are written to give guidance and work instructions to staff about how the persons needs should be met. Senior care staff have responsibility for writing care plans for the people not needing nursing care and the nurses write the care plans for the people who have nursing. We looked at a sample of four care plans. They had been well written in plain English and highlighted individual needs such as W likes to have her food cut up as she cant do this herself and M likes to have her window open a little for some fresh air. Daily records vary with some very good entries but others consisting of settled day, safety maintained which do not give any information about how the person is feeling or what they have done. All of the care plans recorded regular reviews but again the quality varied from excellent detailed and thoughtful reviews to other of remains the Care Homes for Older People Page 12 of 25 Evidence: same, continues to have staff to meet her needs. Residents and their relatives are invited to attend a full review of the care every three or six months, depending on the persons health. A relative we spoke with was very positive about the care her mother receives and confirmed that she has three monthly reviews of the care plan with the nurses. One person has had a pressure sore but this has now healed. A care plan for pressure care was in place and instructed staff that she must be re-positioned every two hours. Where bedrails were in use we saw that they were fitted correctly to the bed and protected with padded covers. Residents have a choice of GPs and a dental service is provided by the local PCT. An optical company provides a visiting service for eye tests and supply of glasses. Residents who are not assessed as needing nursing care receive a service from district nurses. A local chiropodist visits every six weeks and the dates for these visits were shown on a notice-board. The home has adopted the Liverpool Care Pathway for End Of Life Care and works closely with district nurses and community matrons to ensure the end of life is as peaceful as possible. We looked at the arrangements for the storage and recording of medicines. Senior care staff have responsibility for the medicines for residents not receiving nursing care. We found that medicines were all checked in and signed for when they were delivered to the home. Storage was good and secure. The medicine administration records were all fully signed and there were no tablets left in the blister packs that should have been given. When medicines with a variable dose were given the staff recorded whether one or two tablets had been given. Tablets that are not dispensed in blister packs are counted daily and recorded to ensure that the quantities left are correct. Controlled drugs were stored and recorded as required by legislation. Care Homes for Older People Page 13 of 25 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 live at St Oswalds are able to choose where and how they spend their time. Visitors are made welcome and social activities are provided for people who wish to join in. Evidence: An activities organiser is employed for 30 hours a week and notice boards show a lot of activities going on. She was on holiday the week we visited. A resident told us that the activities organiser is great. A separate building across the car park is used for some activities and for storage of activities equipment. There is a structured activity programme that includes one to one and group activities to meet all the needs of the individuals. Outside entertainers and themed evenings are a regular feature of home life and families are encouraged to participate. There was a group of people sitting in the main lounge and chatting to each other. The small lounge was quieter. The conservatory is out of use waiting repair and this has reduced the amount of day space available. In new part of the building most people were in their bedrooms. Some of the bedrooms are personalised with furniture, pictures and other items that people have brought in with them to make their room more homely. Care Homes for Older People Page 14 of 25 Evidence: There is a relatives noticeboard in the entrance area that gives details of forthcoming events. The manager told us that the home has a flexible approach to visiting and relatives/ friends are welcomed at any time of day or night. One of the residents we spoke with said that her daughter comes in to do her hair every week. A visitor we met said that one of the family visits every day for five about hours to help her mother with her meals. She considered that the carers show great affection for her mother and she is always told if mother is not well. The family have decided that it is better if Mum stays in her room as she has a comfy chair and they can read to her. A person from the church comes every week to give communion. Comments we had from a staff questionnaire were The home makes all visitors welcome and residents also. We try to make St Oswalds home from home. We at St Oswalds like to be friendly and are always ready for anyone to offer advice on ways of helping residents to settle in and remain happy. The manager has improved the organisation in the kitchen. She brought in a cook from another home who has a good record in cleanliness and standard of food to give advice to the staff at St Oswalds. New menus and home baking have been introduced. A relative told us that the quality of meals has improved. Menus are displayed in the reception area and in the dining room. Drinks and snacks are provided throughout the day. There is a choice of dishes at every mealtime and we observed people being asked what they would like. The dining room has been refurbished and is very pleasant, although not big enough to accommodate everyone. The tables were nicely laid for lunch and there was a menu on each table. Care Homes for Older People Page 15 of 25 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 who live at the home are protected from abuse and complaints are taken seriously. Evidence: Southern Cross has a complaints policy that is implemented at St Oswalds. A copy is given to new residents and their relatives and a copy is displayed in the entrance area of the home. In the AQAA the manager told us that four complaints had been received in the last year and three issues had been referred to the local authority to investigate possible abuse. The response to a serious complaint that was made in October 2008 is still being finalised. There were good records of all complaints. All of the staff who completed a questionnaire replied that they would know what to do if a resident or their relative expresses a concerns, and the training records showed that in the last year 89 of the staff have done training about abuse. The home manager is a certified Action on Elder Abuse trainer. Care Homes for Older People Page 16 of 25 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. St Oswalds provides a homely, clean and safe environment for people to live in. Evidence: The original part of St Oswalds is a converted Victorian building and a single storey extension was added five years ago. The home is set in extensive gardens in a quiet residential area of Warrington. A full time maintenance person is employed to deal with day to day repairs and there is a maintenance book in the reception area for reporting any faults. All bedrooms are single and 20 have en-suite facilities. A redecoration programme is on-going and residents are able to be involved in choosing colour schemes and soft furnishings. The old part of the building has been much improved with decorating and refurbishment and new doors have made it lighter. Residents and their families are encouraged to personalise rooms to add to the homely feel. Mobility aids, hoists and grab rails are provided and the manager told us that she is able to buy any other equipment that is needed for the care of residents. Some of the double glazed window panes have blown and are full of condensation and need replacing. The home doesnt have a shower room and the shower fitting was missing from a first floor bathroom. Another bathroom on the first floor is not in use and the bath hoist doesnt work. Some of the towels looked old and were a bit tatty. There were trolleys Care Homes for Older People Page 17 of 25 Evidence: with clean linen on in two of the bathrooms and this is not good practice. We discussed this with the manager and she thought better arrangements could be made. When we visited, the home was clean, tidy and free from unpleasant odours. The laundry was well-organised. An environmental health officer visited on 20/7/09 and gave the kitchen a five start top rating. Care Homes for Older People Page 18 of 25 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. Robust recruitment procedures are followed to ensure that new staff are people who are safe and suitable to work with vulnerable residents. Staff receive regular training so they know how to work safely. Evidence: The home employs four nurses and 16 care staff. Another nurse has been recruited and is going through the checking process. The manager told us that recruitment is difficult; there are a lot of care homes and two hospitals in the area. Southern Cross employs a bank of staff who provide cover for sickness and holidays and we spoke with a bank nurse who was working at St Oswalds on the day we visited. He told us that he works there quite often and has got to know the residents. There is also a small use of agency staff. Staff rotas showed that there is always a nurse on duty, with a senior carer and six carers in a morning, a senior and five carers in an afternoon/evening, and three carers at night. One of the people who completed a survey form wrote that sometimes there are only two care staff on duty at night. We discussed this with the manager and she said that she adjusts the rotas according to occupancy and dependency. Earlier in the year occupancy was low so if a member of staff was absent they were not always replaced. In addition to the staff providing care, the home employs an activities organiser, five housekeeping staff, five catering, two maintenance, and an Care Homes for Older People Page 19 of 25 Evidence: administrator. Of the 16 care staff employed, three have NVQ level 3 and five have level 2. (NVQ is the nationally recognised qualification for carers.) The manager has made an application for more staff to do NVQ and is waiting for Southern Cross to give authorisation. We looked at recruitment records for two new members of staff. One person started at the end of December 2008 as a care assistant. She completed an application form giving details of her employment history; two references were provided by previous employers, a POVAfirst check and a criminal records bureau disclosure were received. (These are checks to find out whether the person has any past events that would suggest they are unsuitable to work with vulnerable people.) Her induction training started on 4th January, she had moving and handling training in February, safeguarding training and fire safety training in April, challenging behaviour training in May and she attended a fire drill in June. There were records of supervision meetings with the deputy manager. The second was a young person who has recently started working at St Oswalds as a kitchen assistant. She had completed an application form well and two good references had been received. A POVAfirst check and criminal records bureau disclosure were also on file. She started induction training in June and has attended moving and handling and fire safety training. In the AQAA the manager told us that: On commencement of employment staff are given a contract of employment, handbook and job description. An up to date training chart showed that in the last six months 59 of the staff have had fire safety training and 78 have attended a fire drill. In the last year 89 have had moving and handling training and there has been good attendance at other training for example infection control and nutrition. Staff who write care plans have training about this booked for 5 August. The deputy manager is the moving and handling trainer for the home and a member of staff from Southern Cross estates departments provides the training about fire safety and other health and safety topics. New kitchen staff are doing food hygiene training at another Southern Cross home in Warrington. All of the staff who completed a questionnaire replied that they receive regular training. Staff files are well organised and contain all of the required information and there is an individual training file for each member of staff. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well-managed to ensure that peoples views are listened to and people who live and work at the home are kept safe. Evidence: The manager started working at St Oswalds in December 2008. She was manager of another care home owned by Southern Cross Healthcare before this. She has over 20 years experience in working with older people. She is a first level registered nurse and has the Registered Managers Award among other qualifications relevant to the role. She has not yet applied to be registered with the Commission and must do this without further delay. The deputy manager is not a nurse but is a very experienced carer and has worked at St Oswalds for a long time. She has worked under several managers but said the current manager is brilliant. The manager moved from an office in the reception area to an office in the centre of the ground floor so that she can see and hear what is happening throughout the day. An operations manager visits regularly and we were told that he gives good support. Care Homes for Older People Page 21 of 25 Evidence: An administrator is employed to deal with day to day office work. Southern Cross Healthcare has a comprehensive home audit that covers all aspects of the service. This is completed monthly by the manager and deputy, and in alternate months by the operations manager. Medicines and accident reports are checked monthly, and a random sample of care plans. A staff meeting is held every six to eight weeks and the last was on 1 June 2009, with 13 members of staff attending. A residents meeting was on 7 July and a relatives meeting was planned for the same day but no-one came. A managers surgery is held every week and people can come to discuss any issues. Bi-monthly health and safety meetings are held with heads of departments and minutes from the company health and safety committee are discussed and appropriate action taken as required. The deputy manager has regular supervision meetings with the care staff. Five members of staff filled in our survey forms and four replied that they have individual supervision regularly, and the other replied often. Residents can put small amounts of personal spending money in safekeeping to pay for items such as hairdressing. This is paid into a bank account from which interest is shared. A small float is kept in the home for anyone who requires cash. Individual records are kept and a statement is available by request from the administrator. The maintenance person keeps a file that records the regular safety checks he carries out: this includes a weekly checks of hot water temperatures, wheelchairs, bedrails and fire doors. Emergency lighting is tested monthly and fire drills are held approximately monthly. The names of staff attending fire drills are recorded. The AQAA provided information to show that equipment is tested and serviced as required. Care Homes for Older People Page 22 of 25 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 23 of 25 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 31 8 The manager must apply for registration with the CQC. So that her fitness to manage the service can be established. 28/08/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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!