Care Home: Staplehurst Manor Nursing Home

Similar services:

• The Shelley
• Springfield House
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well The home has good procedures in place for people who are enquiring about the home, and for assessing new residents. This ensures that they will be able to meet the needs of the residents who are admitted to the home. The staff are good at involving residents and relatives in care planning, ensuring that care plans are based on the individual needs of each person, and reflect their individual preferences and lifestyles. A visiting health professional commented that "the staff team make a great effort to treat people as individuals"; and another wrote in a survey that "there is very good care provided for residents by a team of dedicated staff." Documentation for day to day health and personal care is well managed, including suitable risk assessments and detailed care plans. The home has three activities co-ordinators, who work together to provide a wide range of activities to suit different people. Food is well managed, and provides a nutritious diet. Residents particularly like the dessert trolley each day. One of the residents said "I think the chef is excellent". The home is generally well maintained, and kept clean in all areas. Furniture and furnishings are of good quality. The manager ensures that staff are familiar with their different job roles, and this creates an atmosphere of respect and good team work between the staff. The home ensures that residents are at the centre of discussions about any proposed changes in the home, and they know that their viewpoints are regarded as very important. What has improved since the last inspection? The service users guide has been updated during the last year, and a copy is provided in each bedroom. The home has purchased more equipment, including more pressure-relieving mattresses and cushions; and has purchased some new carpeting, furniture, and furnishings. A new medication audit has been implemented, and this helps to ensure that medication is correctly stored, administered and recorded. The manager and an activities co-ordinator have attended a conference in regards to the further development of activities available in the home; and there have been additional links formed with the local community. A new fishpond and water feature have been added to the sensory garden. What the care home could do better: The home is operating well in all areas, and no requirements have been given as a result of this inspection. Key inspection report Care homes for older people Name: Address: Staplehurst Manor Nursing Home Staplehurst Manor Frittenden Road Staplehurst Tonbridge Kent TN12 0DG     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Susan Hall     Date: 0 5 0 8 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 28 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 28 Information about the care home Name of care home: Address: Staplehurst Manor Nursing Home Staplehurst Manor Frittenden Road Staplehurst Tonbridge Kent TN12 0DG 01580891251 01580890150 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.bupa.com BUPA Care Homes (BNH) Ltd care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 31 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Staplehurst Manor is owned and managed by BUPA, who are a recognised provider of care homes. The home is a large original Georgian Manor House, which is set in twenty-four acres of grounds, and has extensive gardens immediately surrounding it. It is situated in the village of Staplehurst, which is near to the towns of Maidstone and Tunbridge Wells. The village includes amenities such as a bank, post office, newsagents and a supermarket. There is a main line railway station nearby; and the home can easily be accessed by car. There is plenty of car parking at the front of the Care Homes for Older People Page 4 of 28 Over 65 31 0 Brief description of the care home house. The home provides nursing and residential care for up to thirty-one residents. Accommodation is provided on three floors, with a passenger lift providing access between floors. All bedrooms are for single use, although some are large enough for two people to share if they wish to do so. Most have en-suite toilet facilities. Current fee levels range from £900.00 to £1200.00 per week, depending on the assessed needs of individual residents. The nursing contribution is deducted from this fee. Additional charges are payable for items such as chiropody, physiotherapy, hairdressing and newspapers. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The home is assessed as having a rating of excellent, three stars. This was a key inspection, which includes assessing all the information obtained by the Commission since the previous inspection, as well as a visit to the home. Information is obtained from phone calls and letters about the service; legal notifications which the home is required to send in; any complaints or safeguarding issues in which we are involved; and an Annual Quality Assurance Assessment (AQAA) provided by the home. This is a comprehensive document which the home is required to complete each year, telling us about ongoing developments in the home, and any changes. We received the AQAA back within the specified timescale, and it was well completed. The visit to the home commenced at 09.00, and lasted until 3.30 pm. The registered manager and the deputy manager were present throughout the day. During the visit, we (i.e. CQC) talked with nine staff (apart from the manager), and five residents; and we observed staff interaction with the residents. We also viewed all areas of the Care Homes for Older People Page 6 of 28 building; inspected medication; and read documentation, such as care plans, maintenance and servicing records, staff recruitment and training files and minutes of staff and residents meetings. CQC sent out survey forms prior to the visit, and received twelve completed forms from residents, staff and visiting health professionals. These contained mostly positive comments, and were helpful in assessing the areas to inspect during the course of the visit. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The home is operating well in all areas, and no requirements have been given as a Care Homes for Older People Page 8 of 28 result of this inspection. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 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 28 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. The home provides clear and detailed information for prospective residents. Good preadmission assessments ensure that the home will be able to meet the needs of residents who are admitted. Evidence: A copy of the statement of purpose, and the service users guide are kept in the reception area, so that they are easily available for enquirers coming into the home. They are well produced documents, and contain all the required information. The service users guide is in particularly large print, making it easier for people with poor vision to read the contents. An index enables people to find specific information. The home also has a well produced colour brochure for initial enquirers. The statement of purpose includes information about the building, and the background of the premises, before going on to explain details of the providers, the manager, staff and facilities. It clearly states that residents are involved in their care planning Care Homes for Older People Page 11 of 28 Evidence: wherever possible, and that the home has service users meetings, and relatives meetings on a regular basis, enabling discussion about the ongoing development of the home. A copy of the service users guide is stored in each bedroom, and this includes day to day information such as meal times, GP visits, arrangements for meeting religious needs, activities and local facilities. A sample piece of material for each staff uniform denoting their category is included, and this is especially helpful for new residents moving into the home. Each resident has a pre-admission assessment at home or in hospital prior to making arrangements for admission. This ensures that the home will be able to meet the individually assessed needs of each resident, and provides the resident with the opportunity to find out more about the home. These assessments are very comprehensive, assessing all aspects of peoples health, mental state, physical wellbeing and social preferences prior to admission. BUPA has their own Quest documentation for this purpose. We viewed three pre-admission assessments, and noted that each assessment was very well completed. Residents are offered a trial visit prior to making a decision about moving permanently into the home. A review is held with the resident and their family or advocate (as applicable) after approximately four weeks. All residents are provided with a contract which outlines the terms and conditions of residency; and which includes the fees payable. Residents may be admitted for short term or respite care if there are vacant rooms available; and the same detailed assessments are carried out. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have a caring attitude, and ensure that residents health and personal needs are met on a daily basis. The nursing staff involve other health professionals as needed. Evidence: BUPA homes use their own Quest documentation for completing pre-admission assessments, admission assessments, and a further review. This is very detailed documentation, and forms the basis for ongoing assessments and care planning. We viewed three care plan files, and each one had been very well completed, providing individual information about the residents health and physical needs; mental state and well being; and their preferred lifestyles. The plans show an awareness of the Mental Capacity Act 2005, and the implications for residents who lose some of their mental capacity and need decisions to be made on their behalf. The care plan files include monthly assessments for items such as falls risks, nutritional needs, moving and handling, continence care, personal hygiene needs, pain assessment, and medication; and the care plans show that residents (or their relatives if applicable) are fully involved with their care planning, and take part in writing down Care Homes for Older People Page 13 of 28 Evidence: their own preferences. For example, the plans show the times the person wishes to get up and go to bed; if they can choose their own clothes; where they wish to sit for meals; and if they like to take part in group social activities. Daily records are written by the nursing and care staff, and include appropriate details of the care given. Care plans are included for all aspects of daily living, and include details such as the type of moving and handling equipment needed; if the person needs assistance with cutting up food or special cutlery; if they need toileting assistance; and if they prefer a bath or a shower. We viewed three care plans, including one for someone who needed wound care. The type of wound dressings are clearly identified, and each wound or pressure sore has separate documentation. A written record is maintained for each time a dressing is changed, so that it is easy to assess if the wound is healing or deteriorating. The manager compiles a monthly list of pressure sores and other wounds, and discusses these with the regional manager. This ensures that there are continuous checks to ensure that appropriate prevention measures are in place, and that equipment such as pressure-relieving mattresses and cushions are being used correctly. The care plans show that other health professionals are involved in providing care, and good records are maintained for these visits. We saw records for visits from GPs, speech and language therapist, dentist, optician, physiotherapist, and dietician. A local GP acts as the homes visiting medical officer, and visits the home at least once per week. The home liaises with the mental health team if needed, and the local hospice. Residents can have additional physiotherapy for an extra cost if they wish to take advantage of this. Medication is well managed, and care plans show that there are regular medication reviews for each resident; as well as a monthly medication audit. The clinical room was seen to be in good order, and medication is correctly stored in locked cupboards. One item (which is a homely remedy) was found to be out of date, and we brought this to the attention of the manager. There are two trolleys for medication administration, which is mostly administered using a monitored dosage system. There is evidence of good stock control. Controlled drugs (CDs) are properly stored, and the CD register is well maintained. If residents wish to self-administer medication, the nursing staff carry out a detailed assessment to ensure that the person fully understands their medication, and can manage it properly. There is a lockable facility in each room for this purpose. We viewed all of the Medication Administration Records (MAR charts) and these were seen to be well completed. All entries are checked and countersigned by two nurses, which is an example of good practice. Any allergies are clearly identified. There is additional documentation for as necessary medicines, Care Homes for Older People Page 14 of 28 Evidence: which enables additional checks for good auditing procedures. Staff were seen to be attentive to residents and their individual needs, and to treat them with respect and kindness. A resident said that the staff are very caring. Staff ensure that residents privacy and dignity are upheld. A health professional stated in a CQC survey form that the home provides a homely atmosphere and excellent nursing care. Care plans include documentation for end of life care, and staff try to ascertain any specific wishes as soon after admission as possible, so that if there is any medical emergency, the staff are already aware. Some staff have carried out palliative care training, and the staff work together to try and keep residents who are dying as comfortable and pain free as possible. They contact hospice nurses for additional advice as needed. Care Homes for Older People Page 15 of 28 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. Residents are enabled to pursue their own lifestyles according to choice, and there is a good range of group activities available. Food is well managed, and is of good nutritional value. Evidence: The homes activities organisers provide a wide range of activities for social events, and for individual one to one input. There are three activities organisers who work together to ensure that residents individual preferences for activities can be met. A monthly plan for group activities is displayed on a notice board in the entrance hall, showing morning and afternoon activities. This enables relatives and friends to know what is happening, so that they can also take part if they wish to do so. Ongoing activities include items such as board games, card games, quizzes, jigsaws, music and movement, coffee mornings, and visits from pat dogs. There are also art and craft sessions, which might include items such as flower arranging or cookery, as well as art. The home is located on the outskirts of the village of Staplehurst, which has several shops such as a post office, bank, supermarket and newsagents, that residents can visit as they wish. It is also very near to a herb garden, and residents are often taken Care Homes for Older People Page 16 of 28 Evidence: to look around it and stay for coffee etc. The home has access to a local ambulance which is used to take residents out for country drives and for trips to place of interest. The activities organisers had recently arranged a pretend cruise to different countries, and had liaised with other staff (such as the chefs) to pretend they were visiting different countries. The themes included staff dressing in national costumes, and meals from other countries. Residents said they really enjoyed this. The home ensures that residents are able to take part in religious observance, and will arrange for ministers or priests to visit as requested. A church service is held in the home twice per month for residents who wish to attend this. Relatives and friends can visit at any time, and are offered drinks and made to feel welcome in the home. There are different communal areas where they can meet together, and this includes different seating areas in the gardens. Residents are encouraged to take part in discussions about changes to the homes decor, and particularly for their own bedrooms. They are able to bring in personal items to make their own rooms more homely. Residents said that the food is excellent, and there is plenty of choice. The chef/cook have a commitment to meeting residents and finding out their likes and dislikes, and any changes they wish to see included on the menus. Residents can start the day with a cooked breakfast if they wish to, and snacks are available at any times, including night times. The home provides a three course lunch, and residents can choose to eat in their own rooms or in the dining room. This is a spacious room, allowing access for wheelchair users; and dining tables are attractively laid with tablecloths and fresh flowers. Menus for the day are displayed on each table. Lunch times include a dessert trolley which is very popular. All food is home made, and is nutritious and well prepared. The menus are assessed by the manager and the chef together, ensuring that the overall menus provide for all nutritional needs. The catering staff are appropriately trained; and are familiar with preparing food for special diets. A resident said the food is excellent. The chefs work to please individual people. Care Homes for Older People Page 17 of 28 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. Residents are confident that any concerns will be taken seriously and acted on appropriately. Evidence: BUPA have recently developed a new complaints and compliments procedure called Managing customers expectations. The home has a folder incorporating suggestions, concerns, complaints and compliments received, so that a broad picture can be obtained from comments received during each month. The home informs the Head Office of all outcomes from this folder each month. We saw that there are usually several written letters of thanks from relatives or friends. There is a suggestions book in the reception area, as well as the complaints procedure. A complaints log is kept each month and this is retained by the manager for confidentiality. The home has received one complaint during the last year, and the records show that this was dealt with appropriately. The procedure promises that complaints will be investigated, and a response made to the complainant within twenty-one days. All staff are trained in the Protection of Vulnerable Adults (POVA) as part of the induction process, and then have additional yearly training. The manager made one referral to the Social Services Safeguarding Adults team during the year, in respect of a concern about an agency nurse. This is currently being investigated, but has not Care Homes for Older People Page 18 of 28 Evidence: reflected adversely on the home in any way. Care Homes for Older People Page 19 of 28 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. The home is well maintained, and provides a comfortable and pleasant atmosphere for residents. Evidence: The home is an original old Georgian Manor House, and is set in extensive gardens and twenty-four acres of adjoining land. The gardens are very well maintained, and the approach to the house is very attractive, with sweeping lawns and mature shrubs and trees. The rear gardens include different patio and seating areas, and a sensory garden. A new fishpond and water feature have been added to this during the last twelve months. There are ramps in place to enable wheelchair users to access different areas. There is an ongoing redecoration programme, and a maintenance man oversees all the day to day repairs and safety checks. These include fire alarm and fire exit checks; hot and cold water temperatures; wheelchair checks, and bed rail safety checks. All radiators are fitted with guards for safety. We viewed all areas of the home, and found it to be generally well maintained and clean throughout. The manager said that the whole building will be due for refurbishment in the next year or so, and this will deal with the outstanding areas in corridors where skirting boards are damaged and paint is scuffed. The housekeeping staff ensure that all bedrooms are cleaned each day, and carry out deep cleaning on a routine basis. Care Homes for Older People Page 20 of 28 Evidence: The home has a variety of communal areas, including a large lounge which is divided into different areas; an adjacent seating area looking out on to the rear garden; a large dining room; and a smaller lounge which is used for a variety of purposes such as formal meetings, staff training, and a quiet area for residents and relatives to meet. There is also a small sitting area at the top of the main staircase. The home is fitted with three bathrooms and a shower room; and the bathrooms have different types of assisted baths so that they are suitable for residents with different mobility or dexterity needs. Disabled toilets are sited near to communal areas, and most bedrooms have en-suite toilets. Two rooms have en-suite showers as well. The home is equipped with suitable hoisting facilities, and pressure-relieving mattresses and cushions; and some rooms have nursing profiling beds. Other equipment is fitted as needed, such as raised toilet seats,and grab rails. A passenger lift provides access between floors, and there is a stair lift to a few rooms which cannot be accessed via the passenger lift. As this is an old building, bedrooms are of different shapes and sizes, and the type of rooms available are carefully considered for their suitability for new residents. Many rooms were seen to contain personal items so that residents feel more at home. The laundry is situated on the lower ground floor, and the staircase door is protected with a keypad lock to prevent falls. The laundry room is divided into dirty and clean linen areas, and has two washing machines and two tumble dryers. It is not an ideal area for staff to work in, but was seen to be very well organised. There is sufficient hanging space for clean clothing. Care Homes for Older People Page 21 of 28 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. Residents find that staff are caring and competent. The manager is encouraging care staff in their training, so that there will be an even higher percentage with NVQ level 2 training. Evidence: The home is a large building with bedrooms spread across three floors, ground, first and second. The numbers of staff reflect the size of the building and the usually high dependency levels of the residents. There are two registered nurses on duty in the mornings, when the home is at its busiest; and one registered nurse at all other times. This is in addition to the manager and deputy managers, who are also trained nurses. The manager and deputy manager are mostly supernumerary, but may cover nursing shifts from time to time. The deputy manager oversees the clinical care, which gives the manager time to concentrate on other management duties. The manager and deputy manager share duties for being on call at night and during weekends. The home usually has six care staff on duty in the mornings; four in the afternoons, five in the evenings, and two at night. There are servery staff who assist the kitchen and catering staff, and who also give out hot and cold drinks to the residents. Other staff in the home include reception and administration staff; laundry, housekeeping and maintenance. Care Homes for Older People Page 22 of 28 Evidence: Care staff are expected to study for NVQ level 2 training if they have not already completed this prior to commencing work at the home. The current level of those who have completed training is approximately sixty per cent, and the home is aiming for an even higher percentage than this. There are good recruitment procedures in place, and staff files are neatly organised into sections so that information can easily be found. We examined three staff files, and they included all required information. This includes a full employment history, two written references, a recent photograph, POVA and Criminal Record Bureau (CRB) checks, proof of identity, and training records. An interview record is retained, and applicants also complete a medical questionnaire and state if they need a work permit. The induction programme is very thorough, and includes all mandatory training during the first four days. This is followed by a three month probationery period. Training records showed that mandatory training is kept up to date, and includes POVA training as well as fire training, moving and handling, infection control, first aid, and health and safety. The manager has been working with other BUPA home managers in the South East region to develop the induction programme, and the initial trials have been very positive. All staff are encouraged to carry out additional training courses. The nursing staff have recently attended a twelve week medication course provided by West Kent college; and some have carried out specific training in palliative care. Staff are also carrying out training in dementia care, so that if residents develop dementia while they are in the home, the staff will recognise it and know how to care for these residents more effectively. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager leads the way in providing effective care for residents in the home. There are good auditing systems in place, which quickly highlight shortfalls in any areas. Evidence: The manager has worked in this home for eighteen years, and has been managing the home since 2005. She has carried out NVQ level 4 training in management and care, and the Registered Managers Award. She has a deputy manager who works closely alongside her, and who oversees all of the clinical care; and who also carries out much of the liaison with relatives. The manager maintains good working relationships with the staff by obtaining feedback on a day to day basis, and through staff meetings for different departments e.g. catering staff; nursing and care staff. There are staff meetings held every month. It was evident throughout the day that staff are familiar with their different roles, and are confident about carrying out their work. Care Homes for Older People Page 24 of 28 Evidence: Residents are able to express their views every day to the management or senior staff; and all staff will feed back any concerns raised to them, to the manager or deputy. The home holds residents meetings every three months, so that residents can express their views as a group, and can discuss possible changes such as different food, outings, or decor. The minutes from these meetings are distributed to all residents.There are separate meetings for relatives, and these are held every two months. This ensures that they are kept informed of changes taking place in the home, and can ask questions. The home provides yearly questionnaires for residents to complete, and the results of these are collated, and are used as a basis for changes. The satisfaction survey from last year had a response rate of ninety-four per cent. The results were very positive, with food, cleanliness of the home, and the state of the communal rooms assessed by one hundred per cent as excellent. Ninety-four per cent rated the staff as excellent. The manager carries out a series of monthly audits which are checked by the regional manager; and which provide an overview for how the home is progressing, as well as identifying any areas of weakness. Residents are able to keep small amounts or personal money stored safely in the home, and these are stored as individual amounts, with individual records. All receipts are retained, and the records can be checked by the resident or their authorised representative at any time. These accounts are audited every month. Staff have formal one to one supervision every two months, and this is allocated to different members of senior staff who have had appropriate training. Records and document management is well handled, and all policies and procedures are checked yearly. We viewed some of the records, such as monthly audits for health and safety, medication, fire safety training and fire drills. Detailed care plan audits are carried out each month. Accident and incident records were seen to be well completed. The AQAA included specific details of other servicing records such as hoist and lift servicing; and these records are kept up to date. Care Homes for Older People Page 25 of 28 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 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 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 28 of 28 - 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!