Care Home: Summerdyne Nursing Home

Similar services:

• Maple Lodge
• Heathlands
• Aston Court Nursing Home
• Breme
• Ravenhurst
• Bank House
• Inspirations
• Ashcroft Hollow Nursing Home

What the care home does well Assessments are carried out by the home manager before people move in, so that people can be confident that the home are able to meet their needs. Each person has a care plan which is based on their individual care needs. The care plans are generally well written and contain good information to ensure that staff know what to do for each person and each person receives a consistent standard of care. The home are able to meet people`s health and personal care needs. There is a range of social opportunities for people living at the home. A variety of choice of meals are available, providing a well balanced and nutritious diet. People can be confident that any concerns will be listened to and acted upon. The home provides a safe, comfortable and well maintained environment for people to live in. Infection control is very well managed. Staff are caring and provide people with care that meets their individual needs with dignity and respect. Staff receive training to give them the skills and knowledge they need to work in the home. The home is managed well, and people can be confident that is is run in their best interests. What has improved since the last inspection? The quality of the information in the care records has improved to ensure staff have the information they need to enable them to meet people`s individual care needs. Specialist diets are being provided where people have been identified as losing weight. Improvements have been made to the storage of controlled drugs to ensure they are being stored securely. The home are monitoring the temperature of the areas where medication is being stored to ensure it is not at risk of being harmed due to excessive heat or cold temperatures. Improvements have been made to the privacy curtains in the shared rooms to ensure people`s privacy is maintained at all times. What the care home could do better: There needs to be clear instructions recorded in the care records when creams, ointments, food supplements and medicine is prescribed `when required`, to ensure staff know why, how and when to administer the medicines. Key inspection report Care homes for older people Name: Address: Summerdyne Nursing Home Cleobury Road Bewdley Worcestershire DY12 2QQ     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: Sandra Bromige     Date: 1 9 0 5 2 0 1 0 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 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Summerdyne Nursing Home Cleobury Road Bewdley Worcestershire DY12 2QQ 01299403260 01299403174 tuulapage@heritagemanor.co.uk Heritagemanor.co.uk Heritage Manor Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Tuula Anneli Page Type of registration: Number of places registered: care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 27 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 27, Old age, not falling within any other category (OP) 27 Date of last inspection Brief description of the care home Summerdyne Nursing Home is situated on the outskirts of Bewdley on a bus route. It is an adapted house with a purpose built extension. The service provides personal and nursing care for up to twenty-seven older residents of either sex who may have physical or mental frailty that requires continuing care. Accommodation is provided in seventeen single rooms, thirteen of which are ensuite. Care Homes for Older People Page 4 of 29 Over 65 0 27 27 0 1 6 0 6 2 0 0 9 Brief description of the care home The remaining rooms are all ensuite double rooms. There is a shaft lift to facilitate movement between floors and there is a small garden and gazebo for the residents. The registered provider is Heritage Manor Ltd. The registered manager is Mrs Tuula Page. Up-to-date information relating to the fees charged for the service is available on request from the home. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We, the commission completed the last inspection of this service on 16th June 2009. This was an unannounced inspection. One inspector spent time at the home, talking to people who use the service and the staff, and looking at the records, which must be kept by the home to show that it is being run properly. The focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. we looked in detail at the care provided by the home for two people. T his included observing the care they receive, discussing their care with staff, looking at care files and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. The manager of the service had previously completed an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well Care Homes for Older People Page 6 of 29 outcomes are being met for people using the service. It also gives us some numerical information about the service. Some of the managers comments have been included within this inspection report. We sent out 10 surveys for people who use the service and 10 staff to the home for completion. It is disappointing that only one survey has been returned to us from a person who uses the service. Some of the comments from the survey have been included within this inspection report. We have not received any complaints or safeguarding referrals for this service since the last inspection. Care Homes for Older People Page 7 of 29 What the care home does well: 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 8 of 29 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed prior to admission to the home to ensure the home are able to meet the persons health and social care needs. The home does not provide dedicated intermediate care. Evidence: The information in the AQAA completed by the manager prior to the inspection told us, individual assessments are carried out prior to admission so that the home has the information required to meet the needs of that person. We involve residents and relatives in the assessment to be sure we know as much as possible about the resident and what they like and want. We looked at the care records for a person who had recently moved into the home. We saw a comprehensive assessment had been carried out for this person so that the service are able to ensure they can meet this persons holistic care needs. Care Homes for Older People Page 11 of 29 Evidence: We received one survey from a person who uses the service. This told us they received enough information about the home before they decided to move in. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall the care records have improved and provide a good standard of information for staff to ensure they have sufficient knowledge to meet the healthcare needs of the people who use the service. The homes management of medication has improved ensuring peoples health and well being are safeguarded. Peoples privacy and dignity is maintained at all times. Evidence: The AQAA told us, the care plan is a comprehensive document which enables us to identify resident needs. Residents and families are included in the care planning process as well as gaining information from comprehensive assesments. These are evaluated monthly and updated when needs change. Resident/relative sign care plan agreement. Individual risk assessments on falls, safety rail use, moving and handling, mental and cognitive ability, nutritional status, mouth care. These assessments and their continuing monitoring ensure residents needs are addressed and any changes identified and responded to quickly. We case tracked the care of two people who use the service and we found good Care Homes for Older People Page 13 of 29 Evidence: outcomes of care for these two people. Overall the care records were well completed and informative. We saw that the people and/or their next of kin had been consulted about their care plan. We saw that formal reviews were taking place and any changes needed were incorporated into the care plan and the information passed to the staff who provide the care for these people. We spoke to staff about these people. They had a good knowledge of the care needs of the people whose care we tracked and where there were gaps in the care records, staff were able to provide this information. Due to staff have a good knowledge of peoples care needs this reduces the risk of people not receiving the care they need where there is information lacking in the care records. Although, it is important to ensure the care records are reviewed and updated at all times when peoples needs change to ensure the care is consistent and accurate records are kept by the home. For example, we saw one person sitting on a pressure cushion to prevent their skin from becoming sore, but this information was not in the care plan. One person had developed pressure sores, a care plan had been put into place immediately, but it had not been reviewed since the 19th April 2010. We saw no wound assessment chart showing the assessed progress or decline of the pressure sores and the frequency of it being checked by the nursing staff. We could see it was being assessed as there were periodic recordings of dressing changes written in the daily records. Care staff told us there were no dressing in use on the day of the inspection, but we were unable to see the current status of the pressure sores from the information in the care plan. We saw in the daily records an entry dated 5th May 2010 stating the person had a graze to right elbow and has dressing on to protect. There was no information on the skin chart or care plan about this. We saw a care plan which stated the carers to encourage X to come out of their room for a walk for short distances. We saw from the mobility care plan and risk assessment, this person was no longer mobile and staff needed to use a hoist to transfer this person. The care plan had been reviewed on the 30th April 2010, but had not been reviewed accurately. We spoke to the people who use the service and we saw they had been helped to look their best by the staff. One person told us the staff are fantastic. a survey from a person using the service told us they look after us. We have received a letter of praise from a relative. This told us, the end of life care in those four days that X received was exemplary. We spent many hours at Xs bedside, while X was dying. It was a very emotional and sad time for us. The staff were attentive and supportive: never intrusive, but there whenever we needed them. When staff attending to Xs personal care felt that X was experiencing some pain, the doctor was called Care Homes for Older People Page 14 of 29 Evidence: immediately, and a prescription for pain relief was issued. We spoke to a local medical practitioner who told us the home give good care to the people who use the service. We looked at the homes management of medication. There have been improvements to the homes management and storage of medication since the last inspection. The home have changed their pharmacy supplier. The medication administration records (MAR) recorded that the medication was being given as prescribed by the GP. There were no gaps and appropriate codes were used to show why the medication was not given, for example refused or asleep. We carried out a number of audit checks of medication prescribed for the people whose care we tracked. They were all correct. This indicates good management of medication by the home. We looked at the temperature of the room and refrigerator where medicines were being stored. We saw the home are recording the temperatures daily and that medicines are being stored within the range of temperatures recommended by the manufacturers to ensure the medicines are not harmed through excessive heat or cold. We saw the home had a new cabinet for the storage of controlled drugs and it was fixed correctly to a solid wall to ensure it complied with the regulations for storage of controlled drugs. There are some areas where the home could still improve regarding the management of medication. Where prescribed creams and ointments are in use, the information about why they are used and how they are applied and how often needs to be in the relevant care plan. Records must be kept of the application of all prescribed creams and ointments to show they are being given as prescribed by the medical practitioner. Care plans need to include detailed information and instructions for staff about medication which is prescribed to be used when required to ensure staff know when and how to give the medication. When food supplements are prescribed for people who at risk nutritionally; the home need to ensure they have accurate records showing the food supplement has been given to the person as prescribed by the GP. We saw staff speaking respectfully to the people who use the service. We saw and heard staff knocking on doors before they entered the room and doors were closed when personal care was being given. We saw that further privacy screening had been provided in a shared room to ensure the privacy of both of the people using the bedroom is maintained at all times. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be confident the home will be able to support them to follow their personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to continue these relationships. People are offered a variety of healthy meals and snacks at a time and place to suit them. Evidence: The information in the AQAA told us, we have a dedicated, full-time activities coordinator in post who offers a variety of activities aimed at physical and mental stimulation e.g. quizzes, chairobics and we have visiting entertainers. Residents are taken out on a trip once a year. Residents are also taken out individually on shopping trips and other social activity. We saw information was recorded in the care records about peoples life history, and hobbies and interests. There was information about activities on the notice board and we saw a newsletter which was available for people about the home and any events planned. We spoke to care and social care staff and they had a good understanding of the peoples individual interests and hobbies. Social care staff told us they spend time with each person each day. They told us they have regular one-to-one sessions with Care Homes for Older People Page 16 of 29 Evidence: people and record their life history and their personal background. They are currently encouraging people to create wish lists and make memory boxes, and the staff are trying to get the families of people who use the service more involved in the social care in the home. On the afternoon of the inspection a poetry group was planned. A survey completed by a person who uses the service told us the staff come and chat to us and confirmed the home offer activities they can take part in. We saw visitors coming in and out of the home throughout the day. Staff made them very welcome. The information in the AQAA told us, the home has a varied flexible menu which is changed to accommodate the preferences of the residents. Cooked meals are offered three times a day and include a full english breakfast if required. The chef is committed to providing a quality service and speaks to residents and their families, he is also committed to maintaining and improving nutritional status. Chef is consulted at the assessment and he is involved in the care planning to ensure the residents favourite meals are regularly provided. We saw the menu for the week displayed in the home and this showed a choice of main meals and desserts each day. The menu of the day was written on the menu board in the dining room for people to see. We saw people were still being served breakfast at 09.30hrs, catering staff told us they will provide a cooked breakfast every day upon request. We saw photographs of the main meal choices and desserts were available to aid people with dementia to make a choice of food. This is good practice. The lunch menu available on the day of the inspection was chicken a la king, duchess potatoes, rice, broccoli, fresh carrots, or ham and beef salad. Dessert was homemade apple pie and cream, diabetic semolina, fresh fruit salad or melon boat. We looked at the nutritional care of the people whose care we tracked. We saw the nutrition care plan stated one needed a fortified diet and one a soft diet. We spoke to the chef and they told us they had been requested to provide these specialist diets for these two people. We saw staff were recording the food eaten by these two people so they can monitor their individual food intake. For one person their nutrition risk assessment had not been reviewed since 31st March 2010. The information in the nutritional screening tool showed this person had lost 4kg in one month. The care plan for pressure sores stated they needed a high calorie diet, but this information had not been communicated to the catering staff by the nursing staff. The care plan stated the person needed to be weighed each week, but the records showed this was not being carried out every week. This needs to be Care Homes for Older People Page 17 of 29 Evidence: addressed by the home to ensure this person is offered a high calorie diet to try and prevent any further weight loss. In response to the draft report, the manager has advised us the home had contacted the GP and family about the deterioration and the person was refusing food. This information is contained in the care records, although the weight loss had not been updated in the nutritional assessment for this person. Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If people have concern with their care, they or people close to them know how to complain. These concerns are looked into and action taken to put things right. People who use the service are safeguarded from abuse. Evidence: The information in the AQAA told us, all new residents and their families receive a copy of our complaints procedure. There is also a copy displayed in reception and in the Service Users Guide, with all appropriate options on where to make a complaint. The complaint procedure is discussed with residents and their families pre admission and made aware of open door policy and importance of raising any concerns. The numerical information in the AQAA told us the home have not received any complaints in the last 12 months. We looked at the homes complaints records and saw they had not had any recorded complaints since 2006. Staff were aware of the homes complaints procedures and the action they should take if they received a complaint. We received one survey from a person who uses the service and this told us they did not know how to make a formal complaint. Care Homes for Older People Page 19 of 29 Evidence: Staff spoken with told us they had received training about protecting vulnerable people, and they were all very clear of the action they would take if they suspected any abuse in the home. We looked at the training records for all grades of staff. We saw there were staff from all grades where there was no recorded evidence that they had received any training about vulnerable adults and protecting people from abuse. This needs to be addressed by the manager. We have not received any complaints and there have not been any safeguarding referrals about this service since the last inspection. We looked at one staff file and it contained a Criminal Record Bureau check for this person before they started work in the home to ensure only suitable people are employed, which protects the people who use the service. Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and well maintained providing a safe environment for the people who use the service. Systems for the management of infection control are in place to ensure the safety of the people who use the service. Evidence: The information in the AQAA told us they have improved the home in the last 12 months through on-going programme of redecoration, replaced some of our beds with profiling beds to ensure we keep pace with the increasing nursing needs of our residents, started to introduce pictorial signage to help people with dementia identify facilities in the home, improved the privacy curtains in shared rooms. We looked at the parts of the home being used by the people we case tracked. The bedrooms were nicely decorated with matching bedspreads and curtains. People had brought in their own furniture and pictures to make their rooms homely. Window restrictors were in place in the upstairs bedroom. These are required by health and safety legislation to ensure the safety of the people who use the service. We looked at the maintenance records for the window restrictors and these show monthly recorded checks of the safety of the windows. All parts of the home were clean and tidy and there were no bad odours. The last inspection report recommended that door locks approved by the fire authority Care Homes for Older People Page 21 of 29 Evidence: are fitted. The provider told us in their action plan that any resident admitted will be asked if they require a lock on their door. All other locks will be addressed as rooms are refurbished. We spoke to the manager after the inspection visit and she told us she makes a point of asking people if they require a door lock. No one has requested one since the last inspection. There is no date at present for this work to be undertaken. As reported on in the last inspection report, the communal space provided in the home needs to be addressed. Their action plan told us, it is recognized there is a need to increase the communal space to improve the daily life of residents. Plans to increase the communal space are still being considered. A Director of the company told us they have undertaken to establish the cost of this work and to provide a covered walkway between the home and the laundry/managers office and staff rest room. This work will be carried out as part of their refurbisment of the service but due to the high cost of this work a timescale has not yet been set for when it will take place. We saw an entry for May 2010 in the daily records for a person whose care we tracked that said the person complained of the lounge being overcrowded. The catering staff told us the staff are no longer using the kitchen as a means of access to the laundry or staff room. The manager told us she has increased the numbers of domestic staff employed to ensure domestic staff are not deployed to work in two areas of the home in one day, for example the laundry and the kitchen. This will ensure there is not any risk of cross infection between these areas, which was a concern at the last inspection. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff provided to meet the needs of the people who use the service. There are shortfalls in training for some staff and this needs to be addressed to ensure staff have up to date skills and competencies to enable them to carry out their role and continue to meet the needs of the people who use the service. Thorough recruitment procedures are in place to ensure the safety of the people who use the service. Evidence: On the day of the inspection there were 22 people using the service. Staff on duty were one registered nurse, four care staff, one domestic, one laundry assistant, a chef and assistant chef and a social carer who was working 12-8pm. The manager was on annual leave and due to return to work the next day. In addition there were two supernumery staff; a lady from college and a student nurse on placement. Staff told us these are the normal numbers of staff for the number of people using the service and when more people are using the service the staff numbers are increased. Staff told us there are enough staff on duty to meet the needs of the people who use the service. A survey completed by a person using the service told us there are always staff available when needed. Care Homes for Older People Page 23 of 29 Evidence: The information in the AQAA tells us the home employ male and female staff from a multi-cultural background. 11 staff have NVQ level 2 or above. The home rarely use agency staff as they have a very low turnover of staff employed. We spoke to a local GP who told us the home has a good reputation and has a stable staff team. Staff spoken with told us about the training they had received in the last 12 months. Overall they had received the majority of their core training, for example moving and handling, fire, but one person told us they had not received any training about safeguarding people. We looked at the recruitment file for one person and they had not received any training about safeguarding people. We looked at the training matrix for staff and this showed there is a number of staff from all grades who do not have any training recorded for safeguarding adults. There were also significant gaps in the training records for infection control, COSHH, and health and safety. This needs to be reviewed and addressed by the manager. The manager told us she and her deputy are starting the Gold Standard Framework palliative care course. This is good practice. We looked at the training records for the nurses for the use of syringe drivers and two nurses had no recorded training and the other nurses had last completed this training in 2008. This needs to be updated and staff who have not undertaken this training need to do so. The manager told us she had undertaken training about the Mental Capacity Act (MCA) and Deprivation of Liberty safeguards (DoLs). Not all of the staff spoken with had undertaken this training, including nursing staff. We looked at the recruitment files for one person. All the information to show the home had undertaken a thorough process of recruitment was available. This ensures only suitable people are employed at the home. We saw this person had undertaken an induction programme which is in line with the Skills for Care Common Induction Standards Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall, the home is well managed to ensure it is run safely and in the best interests of the people who use the service. Evidence: The information in the AQAA told us, the manager is a registered nurse of over 40 years experience, over 20 years of which dedicated to the private sector and the last 6 years in a management role. The manager also holds the registered managers award. The manager updates herself on a regular basis attending appropriate courses to enable her to fulfill her role and a good understanding of the care standards. The manager was on annual leave at the time of the inspection. The nurse in charge of the home was able to provide all of the information needed for the inspection visit. We asked staff about the management of the home and they told us, the manager is very approachable and very nice to talk to. When she is not here the home runs the same. People visit from head office. Staff told us they are very very happy here. Care Homes for Older People Page 25 of 29 Evidence: We looked at how the home monitor the quality of their service and how they consult people who use the service, their relatives and its staff. We saw regular meetings take place in the home with people, their relatives and staff and the minutes of these meetings are recorded and any actions noted have been addressed. We saw the manager holds surgeries for relatives and staff each month, where they can just pop in and have a chat. Questionnaires have recently been sent out asking for comments about the service. This is all good practice. We looked at the way the home manage peoples monies. We saw a robust system is in place which ensure people are protected from any potential financial abuse. We looked at the monthly visits carried out by a representative of the owner. They include the review of records, seeking views from the staff and people who use the service and looking at the environment. This ensures the owner is able to closely monitor the standard of the service and create an action plan for any shortfalls and monitor the homes progress in meeting any identified actions to ensure they continue to provide a good standard of service. We saw the visits are not always unannounced. We advised they must always be unannounced visits to the home to ensure full compliance with the regulation. The numerical information in the AQAA told us all their equipments had been serviced in the last 12 months with the exception of the portable appliances(PAT). We spoke to the maintenance person and they told us the PAT testing is carried out every six months. We saw monthly recorded checks had been carried out to check the safety of the wuindow restrictors in the home. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 9 13 (2) To make arrangements 31/07/2009 to ensure that care plans include detailed information and instructions for staff in respect of the administration and management of medicines, including the reasons to give medicines on a when required basis and what constitutes needed for a named person. To ensure staff know when and how to give the medication. Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 29 of 29 - 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!