Care Home: Stanley House

Similar services:

• Byars Care Home
• St Marys Nursing Home
• Bramble Lodge
• Parkmanor Residential Home
• Thornham Grove
• Hunter`s Lodge
• London Road Neurological and Specialist Care Unit
• Carlton Care Home

What the care home does well People told us they were encouraged to visit the service in order to familiarise themselves with the building, and to enable them to make a informed choice about their future. People are confident that the service is able to meet their needs because an assessment is undertaken before they move into the service. This informs the staff about the support they need and their individual preferences. People have access to a variety of activities, which ensures they have meaningful things to do during the day. People told us about the opportunities they have available and these include outings, external entertainment, gardening and baking. People are encouraged to follow their own interests and hobbies and one person told us: "I go out every week to my art class and I really enjoy it". People live in a well maintained building. People told us they thought the service was "homely with a relaxed atmosphere". People said the routines were flexible and they could choose how they wished to spend their day. People told us they are "very well looked after". They told us the staff team were: "friendly", "caring" and "responsive" and provided "good care and support". Visitors told us they are "always welcomed into the service", and they thought their relative "received the best care". They told us the staff were "genuine" and very "supportive". People told us they liked the meals and choices were "always available". People are supported by a stable and trained staff team who are dedicated to ensuring peoples needs are met to a good standard. People are regularly consulted about the service and the suggestions they make are listened to and implemented which ensures the service is run in their best interests. What has improved since the last inspection? The service have addressed all of the outstanding requirements from their last inspection report. The following improvements have been made: Staff have received training in relation to safeguarding people from risk and harm. This ensures staff are aware of their responsibilities and the action to take if they witness any situations that result in a person being harmed. The service had ensured that they had obtained all of the required recruitment documents for newly employed staff. However we did find shortfalls in the way this information and the timescales of when it was obtained, so therefore this requirement was only partially met on this occasion.The staff have been provided with the required mandatory training to ensure they have the skills and knowledge to fulfill their role. What the care home could do better: As stated above the only area the service did not comply with, was in relation to the way they recruit staff. They need to ensure they obtain all of the required recruitment checks before the staff member commences their induction in the service. This will ensure they are vetted and are deemed suitable to work with vulnerable people. We did receive evidence and confirmation to support that these procedures have already been reviewed to ensure they are accordance with the law. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Stanley House 155 Duffield Road Derby DE22 1AH     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 Williams     Date: 1 8 0 8 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 30 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 30 Information about the care home Name of care home: Address: Stanley House 155 Duffield Road Derby DE22 1AH 01332364734 01332344481 office@willover.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Karen Jenkinson Type of registration: Number of places registered: Willover 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: Date of last inspection Brief description of the care home Stanley House is a 42-bedded Care Home providing nursing care and is situated in a residential area of Derby. It is close to a range of shops and local amenities. The property was originally a private dwelling that has been converted and considerably extended. Peoples bedrooms are located over three floors, which can be accessed via a passenger shaft lift or by a staircase. The service provides limited en-suite facilities. There are a variety of communal areas made available for use at all times. The garden areas are landscaped and accessible to people. The service provides 24-hour staff care, three meals per day, with drinks and snacks provided at regular intervals throughout the day. Personal laundry is attended to and a range of leisure activities is 0 Over 65 42 Care Homes for Older People Page 4 of 30 Brief description of the care home provided by an Activities Coordinator throughout each week. The charges made for a room at Stanley House range from 502.30 pounds to 706.30 pounds a week, dependent on the persons needs, the facilities provided, and whether the room is a double or single room. Care Homes for Older People Page 5 of 30 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 inspection was unannounced and involved a visit to the site which lasted for a period of a day. The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people who use the service and their views of the service provided. This process considers the homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. Where possible, we include evidence from other sources, notably District Nurses and Social Workers. We also use information gathered throughout the year, and since our last key inspection which was undertaken on 5th September 2007 to support our judgments. We undertook an Annual Service Review on 16th September 2008, which is a short report based on peoples feedback. This demonstrated that the service was meeting peoples needs and they were keeping us informed of any significant events. Care Homes for Older People Page 6 of 30 The information we looked at before our visit can include; notifications from the provider, complaints or concerns and the pre-inspection annual quality assurance questionnaire (AQAA), which the provider is required to complete prior to a visit to the service. We received the AQAA within the requested timescale. It was comprehensive in detail and gave us all the information we asked for. The main method of inspection used during the visit to this service was case tracking. This involved selecting four people who use the service and looking at the care they receive through the review of their records, discussion with them where possible, the care staff and observation of care practices. What the care home does well: What has improved since the last inspection? The service have addressed all of the outstanding requirements from their last inspection report. The following improvements have been made: Staff have received training in relation to safeguarding people from risk and harm. This ensures staff are aware of their responsibilities and the action to take if they witness any situations that result in a person being harmed. The service had ensured that they had obtained all of the required recruitment documents for newly employed staff. However we did find shortfalls in the way this information and the timescales of when it was obtained, so therefore this requirement was only partially met on this occasion. Care Homes for Older People Page 8 of 30 The staff have been provided with the required mandatory training to ensure they have the skills and knowledge to fulfill their role. 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 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 30 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 30 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. People have access to updated information, to assist them to make an informed choice about moving into this service. Evidence: The manager told us in the information supplied about the service, they allow residents and their families and friends to make informed choices about their preferred place of care. They have a comprehensive Statement of Purpose available in reception and peoples have a guide to the service in their bedroom. They told us they conduct a thorough pre-admission assessment to ensure that needs can be met and arrange trial visits if required. People we spoke to told us they were provided with information, on their arrival to the service. The feedback we received in the surveys also confirmed this, and people said they had sufficient information to decide if this service was right for them. Care Homes for Older People Page 11 of 30 Evidence: People who we spoke with, told us they were encouraged to visit the service in order to familarise themselves with the routines and to meet the staff and people. One person told us: I came for a visit and this helped me to make my decision. We looked at the records in four peoples files, and these demonstrated that an assessment of their needs had been undertaken before they moved in. This ensures people move into a service that can meet their needs. Care Homes for Older People Page 12 of 30 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. Each person has a plan of support which covers their personal, and healthcare needs. This ensures peoples needs are met. Evidence: The manager told us in the information supplied about the service that each person has a nominated named nurse who is responsible for formulating an individual plan of care for them. They told us that were possible the person is involved in this process and is encouraged to actively participate in any decision regarding their health or care. They told us they offer access to a GP service and hold in-house surgeries at least twice weekly. They said they have a safe and effective system for dispensing medication within the service, and they work hard to promote the privacy and dignity of people. We looked at four peoples care more closely and looked at their care files. Each file we looked at contained an updated plan of care, which had been completed in sufficient detail to inform the delivery of the persons care. Some additional information was provided within the care plan to reflect peoples preferences on how Care Homes for Older People Page 13 of 30 Evidence: they would like to be supported. This ensures people receive individualised care which meets their expectations. Each care plan that we sampled contained the required risk assessments that should be undertaken to monitor peoples mobility, pressure areas, nutrition and falls. These were reviewed as required. The care records that we sampled and discussions with people confirmed that contact with external health care services is routinely made. There was evidence in the files to support that the plan of care is reviewed on a regular basis. People told us they are consulted about their plan of care and the records seen demonstrated this. We spoke to some visitors who was in the service during our visit. Some of the comments made include: I visit my relative on a regular basis, and I am always welcomed into the service. The staff are very caring and are so genuine in the way they look after people and my relative. I think the staff are great, and they always keep me well informed. The staff are really good and very caring, my relative said they are quite happy, and that makes me happy. All of the people we spoke to told us they receive support which is provided in a safe, respectful and dignified manner, and our observations, supported this. People we spoke to made the following comments about the care they receive: The staff are very kind and gentle when they support me with my personal care, they never rush me and are very patient. The care we receive is very good, and they encourage us to do things for ourselves which is good, I am happy with everything The staff are very friendly, and approachable. They take great care of me and call the doctor whenever I need him. When we looked at the arrangements for the handling and management of peoples medicines by the service, we found these to be satisfactory and people were receiving their medication as prescribed. Care Homes for Older People Page 14 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use services are able to make choices about their life style. Social educational, cultural and recreational activities meet peoples expectations. Evidence: The manager told us in the information supplied about the service; they endeavor to identify peoples preferred activities and offer these where possible and appropriate. They enable people to see their relatives and guests at a time convenient to themselves (in a private area when requested). They told us people are encouraged by all members of the team to retain control over the decision making processes in their lives. They said they provide a varied nutritionally balanced menu within the home offering people choice at breakfast and lunchtime. The kitchen staff cater for individual likes and dislikes and can arrange for specially requested foods to be bought in as appropriate. They also told us they encourage people to continue to pursue their hobbies and interests giving them appropriate support to do so. People we spoke to and the feedback provided in the surveys confirmed the information provided in the self assessment. People told us they were happy with the provision of activities provided, and they confirmed they were consulted about what activities they would like to participant in. This ensures their social needs and Care Homes for Older People Page 15 of 30 Evidence: preferences are met. People told us they really enjoyed the trip out yesterday where they went to the monkey park and had a picnic. People said it was a great day out lots of fun, we had a brilliant time. People told us they have regular trips out at least once a month, and they have entertainment that visit the service which they really enjoy. People said they can join one of the many groups in the service if they wished and these consisted of a poetry group, baking, crafts, reminiscence and a garden group. One person showed us the tomato plants they had grown, which they were proud about. The service has a sun room, which is used as a activities room, and has pictures of previous famous people, and posters as part of remembering our past theme. People told us they liked this room and the display on the walls. We spoke with the designated activities person who told us she meets with people to discuss what activities they would like to participate in, and what trips and entertainment they would like. She told us, people take the lead and I facilitate and plan everything. A separate file is in place and records are completed of the activities undertaken by each person. We also looked at peoples life maps and their likes and dislikes which were also recorded. Although people did not have a social care plan completed in their care plan, their was sufficient evidence (i.e from the records and comments people made to us) to support that their social needs were being met to their satisfaction. People told us they were able to choose how they wished to spend their day, and if this resulted in them remaining in their room, this decision was respected. During our visit we observed people listening to music, having their nails manicured, visiting the hairdresser, knitting and reading. People were also observed assisting staff with tasks such as folding napkins and wiping medication tots. We joined people for their lunch-time meal. The tables were set with tablecloths and condiments so people could help themselves. People told us they have choices, at each meal time and observations supported this. We visited the kitchen and spoke with the catering staff who were able to show us records of peoples dietary requirements. The catering staff were observed asking people their choice for the lunchtime meal and assisting them after their lunch which is good practice. We looked at training records which demonstrated the cook was qualified to work in the kitchen, and she demonstrated a good knowledge of peoples food preferences. Care Homes for Older People Page 16 of 30 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. Systems in place ensure people have confidence to raise their concerns, and are safeguarded from harm. Evidence: In the self assessment we received, the manager told us they encourage both positive and negative feedback about the service. They said they acknowledge, fully investigate and respond promptly to any concerns raised. They told us they ensure that people are able to live in a safe secure environment, by incorporating thorough risk assessments into their care plans. During our discussions with people they told us they knew how to complain and they said they would not hesitate to raise any issues with the staff team or manager. The feedback provided in the surveys also confirmed that people was aware of how to raise any concerns. People told us they have access to the complaints procedure in the information they have been provided with and the procedure is displayed in the service. The service has received 4 complaints since our last visit. All of these issues have been investigated and closed to the satisfactory of the complainant and the records demonstrated this. Care Homes for Older People Page 17 of 30 Evidence: The staff we spoke to demonstrated their awareness of both the complaints procedure and their role and responsibilities concerned with dealing with any potential abusive incidents. The staff and the records we looked at demonstrated they had received training in these areas. The service have not had any safeguarding incidents since our last visit. The manager told us in the information provided in the self assessment that training will be planned for all staff around the Mental Health Capacity Act, and Deprivation of Liberty. This will ensure staff are aware and promote peoples rights to make decisions and ensure they are clear about how to safeguard people. Care Homes for Older People Page 18 of 30 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 benefit from living in a clean, safe and well maintained building. It is homely in design which makes people feel comfortable. Evidence: The manager told us in the information supplied about the service; the home is comfortable and retains many of its original features, and has been sensitively adapted for use as a care facility. They said they have an on-site maintenance team who are available daily. They exceed the minimum standards for communal space and provide a variety of well appointed lounges to meet the varying needs of people. They told us they provide a range of bathing facilities adapted to suit specific needs of people, and have a variety of specialist moving and handling equipment. They liaise with Community OT and Physio where appropriate for advice and assessment of individuals. They also told us peoples bedrooms are tastefully decorated and furnished to a good standard which is regularly reviewed, and they encourage people to bring in their own furniture and personal belongings wherever possible. We undertook a brief tour of the building and all areas we visited were found to be clean, comfortable, homely, warm and well lit. We found all of the information in the self assessment to be accurate and people do have a variety of communal areas to use. All areas were furnished and decorated to a good standard apart from the toilet areas, which would benefit from being renewed as they are looking worn, clinical and Care Homes for Older People Page 19 of 30 Evidence: not homely. People confirmed they are encouraged to personalise their bedrooms and those visited reflected peoples preferences. People told us the building suited their needs, and they confirmed they had access to equipment which encouraged and promoted their independence. People told us: I love my room I have excellent views, and I have brought my photos to make it as homely as possible. The building is very homely and I really like the original features. We have plenty of space to move about in, and the small lounges are great for when our visitors come or if you want some quiet time. I also like the sun lounge and the posters it brings back memories. Staff staff told us We have all of the required equipment we need on each floor which is great and helps us to do our job People told us they enjoy sitting outside in the patio area, and we observed people and their visitors making good use of this area during our visit. There is a ramp, by the door of the sun room, which ensures all people can access this area. Care Homes for Older People Page 20 of 30 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 adequate 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 trained staff team, but the recruitment practices do not safeguard them from potential risks. Evidence: The manager told us in the information supplied about the service; they provide the required staffing levels to meet assessed needs of people, and additional staff are provided at peak times. They said staff receive a thorough induction programme which meets Skills for Care requirements within the first six weeks of employment, and all new members of staff are expected to progress onto an NVQ Level 2 Care programme after completing their induction. They said care staff are allocated mentors and receive supervision on a regular basis, and they operate thorough recruitment procedures based on the regulations. They said 2 written references are obtained and all staff are screened through the CRB system with appropriate identity requested, and POVA information is obtained pending CRB information. During our visit we observed that sufficient staff members were on duty in order to meet peoples dependency needs. Staff, people and their visitors confirmed this and people told us: there is always enough staff on duty to help us we never have to wait long. Observations supported that additional staff was on duty at peak times to assist people. We received positive feedback in the surveys and in the discussions we had with people, about the staff and some of these include: Care Homes for Older People Page 21 of 30 Evidence: The staff are excellent, they are so friendly and respectful and nothing seems too much trouble. The staff are great with my relative, you can tell they genuinely care. They have nice banter with him and this is lovely to see. I have lived in many homes and I think the staff in this one are the best, I have nominated them for an award, as I think they are that good. All the staff are very friendly and they work well as a team so it creates a nice friendly and warm atmosphere in the home. I like living here, this is a good home and the staff are good at their job. Discussions with the staff team demonstrated their enthusiasm, commitment and motivation to ensuring they support people to a good standard. Staff told us they have access to positive training opportunities and the records confirmed this. There was also evidence to confirm that new staff members have a mentor and are supervised until they have completed their induction. We received surveys from staff and some of their comments they made include: We receive regular updates about peoples needs and any changes. We have good training opportunities and we are well supported. This is one of the best homes I have worked in, I am well supported and have good training opportunities. We all strive to provide the best care for people, and the atmosphere here is friendly and homely. We looked at three newly employed staff members recruitment files. We found shortfalls in the way people had been employed, and this was an area we had identified previously. We found that the application form did not request the dates that people commenced and left previous employment, and therefore a full employment history had not been obtained for two of the staff. We found that one staff member had commenced employment with a CRB from their previous workplace. We found evidence that two staff had commenced employment before their second reference had been obtained. These shortfalls have the potential to place people at risk. Immediate action was taken when these shortfalls were identified to safeguard people which included; the review of procedures, new records implemented and training Care Homes for Older People Page 22 of 30 Evidence: provided to office staff to ensure they are aware of the regulations. Care Homes for Older People Page 23 of 30 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 service is managed based on openness and respect, and consults people regularly to ensure it is meeting their needs. Evidence: The manager told us in the information supplied about the service: -that she is an experienced manager who is a registered nurse and she has held previous management positions and has achieved an NVQ4 Level 4 in management and Registered Managers Award. She told us she operates an open door policy and a proactive approach. She said she is a qualified moving & handling trainer and has experience in teaching. We were told there are robust procedures for dealing with peoples finances and they operate strict accounting controls. Safe working practices are promoted at all times within the workplace, and equipment is regularly maintained and serviced. They told us they have developed a comprehensive training programme that covers all Mandatory training required under Health and Safety Legislation. We found the information in the self assessment, to be accurate and the manager is a Care Homes for Older People Page 24 of 30 Evidence: qualified nurse who has had experience of managing a service previously. She works as part of the team as one of the qualified nurses that must be on duty. The manager does not currently have any supernumerary time in order to complete management tasks. This means she has to fulfill her role as a qualified practitioner in addition to fulfilling all of the required management tasks. This has the potential to impact on the service delivery, as she is unable to focus solely on her management role. An example of this is the shortfalls found in relation to the recruitment practices. As the service has addressed these shortfalls immediately and provided us with evidence of the action they have taken to safeguard people, our judgement in this outcome area will not be affected by this breech, as they have now demonstrated compliance in this area. People, their relatives and feedback provided in the surveys told us that the manager does a really good job at managing the service. She has been in post for a year and people told us; the improvements are brilliant, this service is managed perfectly now. Comments received include some of the following: The manager is the best I have ever had and I have been in several homes so I should know. She is kind, approachable, and has made lots of improvements here, she always has time for us. I think she manages this service in our best interests, she is great. The manager is excellent, she has made lots of good changes and we get to go out more which is great, she even joined us yesterday and worked very hard pushing us around all day in our wheelchairs. She is good and I like her. The atmosphere is great here now we have this new manager, its all relaxed and I do feel like this is my home, and this is thanks to her and the staff members hard work. People told us they are consulted about all aspects of the service delivery, both informally and formally at the monthly meetings they have. People said they raise any comments in this meeting and discuss anything they are not happy with or advise staff on any improvements they think could be made. We looked at the minutes of these meetings which supported these comments. The staff members we spoke to, told us they felt supported in their role, and told us the manager is always available, and the office door is always open, we only have to ask for help. Staff members commented on the improvements to the service since this manager commenced employment. The following comments were made. Care Homes for Older People Page 25 of 30 Evidence: The manager is excellent and is always available for support. She manages this service to the highest standards and peoples care always comes first. I feel very well supported and feel very happy working a the atmosphere is so good and everyone works well together We have good leadership and direction and regular staff meetings so we can discuss any issues. It is a well managed service. Improvements have been made since our last visit in respect of the mandatory training undertaken by staff. Feedback from staff and the records demonstrated that staff have completed all required mandatory training. Staff moving and handling practices have also improved with safe practices observed throughout our visit. We were informed that a quality assurance process has already been completed and we were able to look at the findings and analysis from this. The report demonstrated that a variety of people and stakeholders were consulted and that people were generally satisfied and pleased with the service provided. The report included the action that would be taken in response to the comments made and the improvements suggested. This ensures the service listens and acts on peoples feedback and is committed to continually developing the service. People said they were happy with the way their personal money was managed. We looked at the systems in place and these were satisfactory. A delegate of the provider undertakes monthly visits and completes a report of their findings. This is to monitor the standards in the service and to ensure it is meeting peoples needs. The reports covers the required areas (although some areas were brief in detail), and indicated that standards have been maintained on a monthly basis. The service continues to keep us informed of any significant events in the service. They completed their self assessment within the timescale provided and the information was detailed and covered all required areas. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 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 29 19 Staff must not commence 26/10/2009 employment before the following information has been obtained: 2 references, a full employment history,a new enhanced CRB. This is to ensure people in this service are safeguarded. 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 2 1 3 The name and contact details for CQC should be updated in all records that are applicable. The service should confirm in writing to the person that having regard to the pre-admission assessment the service is able to meet their needs. Handwritten instructions should be checked and countersigned by two staff to ensure they are accurate. A care plan detailing peoples social needs and expectations should be completed in consultation with each person. The safeguarding training provided to staff, should include information about the external agencies that staff are able Page 28 of 30 3 4 5 9 12 17 Care Homes for Older People 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 to contact if they have any concerns about a person. 6 31 The manager should have designated supernumerary time to ensure she is able to focus and complete all of the required management tasks. Care Homes for Older People Page 29 of 30 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. Care Homes for Older People Page 30 of 30 - 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!