Care Home: Sunnycliffe House

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What the care home does well People living in the home are offered a spacious, comfortable and homely environment that has recently been further improved with considerable external repairs, and internal re-decoration and refurbishment. Each resident has an individual plan of care to ensure that care needs are met and peoples` choices and preferences for how they receive their care are respected. Comments and feedback from people living in the home are positive and one person told us they find the home `cheerful and friendly`. What has improved since the last inspection? The home has completed a new extension that provides additional bedrooms with ensuite facilities, a new medication room, hairdressing room and lounge/conservatory. The grounds have been landscaped to provide an attractive and accessible area for the residents. A new passenger lift to access the upper floors has been installed. Bedrooms on the top floor are being refurbished and decorated. The home has developed a person centred system for providing comprehensive and individual care plans. Systems for organising and dispensing residents` medication have improved to ensure that residents receive their medicines safely and as prescribed. What the care home could do better: We did not identify any regulatory requirements during this visit. Key inspection report Care homes for older people Name: Address: Sunnycliffe House 20/22 Broadway Sandown Isle Of Wight PO36 9DQ     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: Annie Kentfield     Date: 2 5 0 9 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 30 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 30 Information about the care home Name of care home: Address: Sunnycliffe House 20/22 Broadway Sandown Isle Of Wight PO36 9DQ 01983403844 01983401020 sarahsunnycliffe@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: St Vincent Care Homes Ltd care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 46. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP) Physical disability (PD). Date of last inspection Brief description of the care home The home is a large detached building in Sandown with gardens and car parking. A new extension has been completed to provide additional well appointed bedrooms (some with sea views), a medical room, a hairdressing room and a new lounge/conservatory. The fees may vary and information is available from the home. There are additional charges for hairdressing and chiropody. The home provides four 2 5 0 9 2 0 0 8 46 0 46 Over 65 0 46 0 Care Homes for Older People Page 4 of 30 Brief description of the care home sitting rooms and a large dining room. The building is accessible and there is a passenger lift to access the upper floors. 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: We made an unannounced visit to the home on 25 September 2009 with one inspector. Over a period of seven hours, four of the residents, four members of staff, the responsible individual and the head of operations were involved in the visit. We were shown around the home and spoke to residents and staff individually and privately. We also looked at records of care planning, staff training and recruitment, and some of the health and safety and management records for the home. Before the visit we received the Annual Quality Assurance Assessment (AQAA) from the home. This is a self-assessment that gives us information about the home, what the home does well, and where further improvements are planned. In the interests of seeking peoples views about the service provided; we sent surveys to the home for distribution to ten residents, ten members of staff, and five health and social care professionals. These were sent with stamped, addressed envelopes for Care Homes for Older People Page 6 of 30 confidential return. We received completed surveys from three residents and four members of staff. We consulted with the Local Authority Social Services Safeguarding Team about the outcome of recent safeguarding concerns. We received information that a safeguarding investigation had been completed and closed and that issues of concern had been promptly and appropriately addressed by the service. An interim management structure has been put into place with clear lines of accountability and line management to ensure the effective running of the home in the best interests of the residents. Care Homes for Older People Page 7 of 30 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. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 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 9 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. New or prospective residents are provided with information about the home and the services provided. A pre-admission assessment is always undertaken to ensure that the home is able to meet peoples needs and provide any equipment that may be needed. Evidence: Since the last inspection visit the home has been extended and is now able to provide care for up to 46 people. The responsible individual told us that prospective residents and/or their family or representative can visit the home to look at available rooms and people are invited to spend time in the home or arrange a trial period of stay. Following confirmation of someone moving in, a contract is signed by the resident or their representative and a copy given to the resident. We received surveys from three people who live in the home and two people confirmed they had received a contract and one person was not Care Homes for Older People Page 10 of 30 Evidence: sure. We looked at the assessment of care needs for a person who moved into the home very recently. The home has introduced a new care planning system and the assessments contain more detail and are person centred. This means that the assessment focuses on the health care, psychological and social care needs and preferences of each person and gathers relevant information that is used to draw up a detailed and individual plan of care. The assessment that we looked at contained details of how many carers would be needed to meet the assessed care needs, with specific information for staff on the choices and preferences of the person, in how they prefer care to be provided. The assessment provided details of the specialist equipment that would be needed to meet the persons care needs. People moving into the home are provided with written information about the home. We looked at a copy of the Statement of Purpose and the Service User Guide. These contain information about the home and what people can expect when they move in. The responsible individual told us that information about the home could be provided in other formats if required. The information in the service user guide needs to be updated to reflect the change from Commission for Social Care Inspection to Care Quality Commission from April 2009 with a new address and telephone contact number. This will ensure that people know how to contact the commission if and when required. Care Homes for Older People Page 11 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. People have access to health care services and their health care needs are met with privacy and dignity. Medication is securely stored and dispensed to ensure that residents receive their medication, as prescribed. Evidence: Since the last inspection a new care planning system has been introduced; this uses a computerised system for organising all of the information about each persons care needs. The transfer of all care records to the new system is almost complete, however, some of the care records are still stored using the old record system. We were told that this is being addressed to ensure that the care records for each resident are organised and easily accessible for staff. We looked at the care plans for three people and also looked at medication records. The care plans contained clear guidance for care staff on how care should be provided; for example, details of equipment and number of staff need to support a resident with mobility, continence care plan with guidance on how continence needs are to be met. The care plans also contained a summary of information about each resident, their Care Homes for Older People Page 12 of 30 Evidence: likes and dislikes and personal preferences and choices about how they want to receive care. One care plan contained detailed information about how a resident likes to use the wheelchair and the need for a special cushion. Any risks to residents such as the risk of falling, or the risk of developing pressure areas are assessed with a plan of care about how the risk will be managed. One care plan contained a risk assessment about the need to use bed rails. The risk management plan had been agreed and signed to demonstrate that the resident and their representatives had agreed to the plan of care and how risks would be managed. The care plans demonstrate that staff have clear guidance on what they must do to meet the health care needs of the residents. This ensures that people receive care in the same way from different carers. The Annual Quality Assurance Assessment told us that the home arranges visits by GPs and other health care professionals and will also accompany people to the GP surgery or dentist, if preferred. Care plans are reviewed monthly to identify any changes to care needs. Care staff keep a daily record of care provided. Some of the daily records did not contain sufficient detail to demonstrate that care had been provided to meet the persons care plan. The responsible individual told us that this has been identified as an area for improvement and we were told that staff training in report writing is being planned. Since the last inspection of the home, a new medical room has been built. This has improved the storage for medication and provides a secure area for medicines and related records. Any controlled drugs are stored in a cupboard that meets current legal requirements and the records for controlled drugs were correct and up to date. People who have been prescribed medicines to be taken as and when required have an individual care plan so that staff have clear and written guidance for why and when these medicines should be offered. The Annual Quality Assurance Assessment told us that staff who dispense medication have received appropriate training in the safe administration of medication. Staff have access to a medication policy and procedures and up to date information about medication and good practice guidance. We looked at some of the medication administration records. We found a gap in the records for one medicine on one day, and the amount of medicine in stock had not been recorded. This means that we were not able to check whether the resident had received the medicine or not. Staff in charge of the home told us that this would be investigated immediately. Care Homes for Older People Page 13 of 30 Evidence: The home have told us about a recent incident involving a medication dispensing error. The home has an open reporting procedure and any incidents in the home that affect the safety and well being of the residents are promptly reported to the commission and to Social Services Safeguarding Team, if there is a safeguarding concern. The responsible person and the operations manager for the home told us that immediate action has been taken to reduce the risk of medication errors; procedures have been reviewed and a new operating procedure is in place for medication. We spoke to a member of staff about the new procedures and they confirmed that the new system is working and staff have specific duties and areas of responsibility in a more organised way. The privacy and dignity of people living in the home is promoted: the AQAA told us that people have access to cordless telephones so that they can make and receive phone calls with privacy. Bedrooms, bathrooms and toilets are lockable to ensure privacy. Most of the bedrooms have en-suite facilities. Residents personal laundry items are labeled to ensure that they are returned to them. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home aims to provide a choice of social and leisure activities to meet the different preferences of each resident. People are offered freshly prepared meals in an attractive setting. Visitors are made welcome. Evidence: We were told that the home has a newly appointed activities co-ordinator and the name of the person had been displayed on a notice board in the entrance hall. The information says that events are being planned such as trips out, flower arranging, visits by PAT (pets as therapy) dogs, and asked for further ideas for activities from residents. The AQAA states that an activities photo board and large print time table are being developed as well as a reminiscence picture board for the benefit of residents. We were told that manicures and hand massage are also offered to residents. During our visit staff and residents were involved in a slide show in the main sitting room and we were told that there are games and musical activities arranged at other times. Care Homes for Older People Page 15 of 30 Evidence: We spoke to three residents; two people said that they joined in with activities if it was something they liked. One person who prefers to spend time in their room felt that there was not enough for them to do that they liked. We were told by the responsible person that the home plans to develop more individual activities with one to one contact, for residents who prefer this. The annual quality assurance assessment says that some residents are supported to take part in activities using flash cards and that menus are available in picture format. The comments in the surveys from two residents: stated that there was always an activity to take part in. Staff told us that when they have time, they organise bingo or games activities. One member of staff told us that they bring in DVDs of films that the residents like to watch. We observed the lunchtime routine, some of the residents like to have their meals in their rooms and some residents prefer to eat in the dining room. There are usually two sittings for mealtimes. The dining room is a large and pleasant room with matching tables and chairs. Tables are decorated with table cloths, table mats and flowers to make the dining room look homely and attractive. We noted that although clean, the table cloths had not been ironed and we were told that this would be addressed. One of the residents had a family celebration and this was being held in the smaller sitting room, for privacy. It is evident that visitors are always made welcome in the home. Residents that we spoke to said that the food and meals are good. The AQAA told us that menus have been reviewed to ensure that residents are offered varied and attractive meals. Residents were asked in the surveys if they like the meals; one person said always and one person said usually. The AQAA also says that the home has a car available for the use of residents trips out. One resident told us that they like to sit outside in the sunny courtyard area and have enjoyed seeing the garden (that has now been landscaped). The garden has a level and accessible footpath for residents with a range of trees, shrubs and raised flower beds. There is seating arranged outside so that residents can enjoy the garden in the warmer weather. Some of the residents have been growing tomato plants. 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. Residents and their representatives have access to the homes complaint policy and procedure. The views of people are listened to. People are protected by the homes policy and procedures for safeguarding residents from harm or the risk of abuse. Evidence: At the last inspection visit staff did not have access to an up to date policy and procedures about action to be taken in the event of alleged or actual harm or abuse to people living in the home. The responsible person and the training officer confirmed that staff now have access to the information they need and staff have either completed safeguarding training or are in the process of doing this. In the two surveys that we received from residents, people told us that they knew who to speak to in the event of having a complaint or concern. The home told us in the annual quality assurance assessment that one complaint had been received in the last 12 months and that the complaint was resolved and not upheld. We received information from the Local Authority Social Services Safeguarding Team about a recent safeguarding investigation. We were told that the service responded promptly and appropriately to the concerns and immediate action was taken by the home. The concerns were with regard to staffing and the management of the home. We were told that the concerns had been due to a lack of clarity and communication regarding the interim management arrangements for the home. We saw evidence of Care Homes for Older People Page 17 of 30 Evidence: the plan of action in place to ensure that residents were safe and their well being protected. Staff told us that the new working structure for the home had improved the way that the home is managed and run. The service always notify us of any events in the home that affect the safety or well being of the residents and also work closely with the Local Authority Safeguarding Team if there are any events that affect the safety or protection of the residents. 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. Residents live in an environment that is comfortable, homely and well maintained. The home provides a wide choice of communal space for the benefit of people living in the home. Good practice is promoted to maintain a pleasant and hygienic home for people with procedures in place for the prevention of infection. Evidence: The current owners of the home have undertaken extensive repair and refurbishment of the building including; external repairs, replacement of the passenger lift and completion of a large extension to the main building. Since the last inspection, new bedrooms have been completed in the new building and a large conservatory/sitting room has provided additional space for the residents. A new medical room, sluice room, and laundry room have been installed. Work is ongoing on the top floor of the main building to refurbish bedrooms and en-suite facilities and replace carpeting and flooring. The large ground floor sitting room has been divided to create two areas; one area can be used for private meetings and parties if residents choose. On the first floor there is an additional sitting room that can be used by residents or for staff meetings, or staff training. Residents have access to a sunny garden area that is level with paved areas that are suitable for people who use wheelchairs or walking frames. The garden has been Care Homes for Older People Page 19 of 30 Evidence: landscaped with lawn, trees, shrubs and plants. Some of the bedrooms in the new building open onto the garden. The remaining outside area provides parking and we were told that it is planned for the driveway and parking area to be re-surfaced in the near future when all of the refurbishment work is completed. The new bedrooms are furnished to a high standard and have en-suite facilities, and flat screen televisions installed. The laundry room and sluice room are equipped with lockable doors to ensure that residents are safe. Bedroom doors are fitted with attractive nameplates and easy to use lock systems to support residents who may be frail or confused. We spoke to two residents in the conservatory/sitting room. Both residents told us they liked sitting in the conservatory because it was sunny and pleasant and they had a good view of the garden. We spoke to a resident who has a room in the new building and they told us that they had everything they need. We saw that people are provided with footstools and cushions in the sitting rooms, where this may be required. The ground floor sitting rooms also provided baskets of fruit and snacks and jugs of water or juice, for residents to help themselves. The registered provider showed us new storage areas for the kitchen and a second staircase has been blocked off to provide storage space for wheelchairs and other essential equipment. We were told that there are plans for the kitchen to be completely refurbished. Bathrooms and toilets are clean and pleasant and there is also a spacious shower room. Bathrooms are fitted with overhead hoists and specialist baths to meet the needs of residents who need assistance with bathing and personal care. Residents have access to a call bell if they require some help. The system in place means that staff have a pager and can check the status or location of an alarm call even when they are some distance away. We spoke to two residents who told us that staff always respond if they use the call bell to ask for assistance. Discussion with staff confirmed that equipment to prevent infection or cross infection is available for staff, such as gloves and aprons. Comments received from three residents in the surveys confirmed that the home is always clean and pleasant. Care Homes for Older People Page 20 of 30 Evidence: We spoke to a member of staff in the laundry who told us that effort is made to ensure that people always receive their own personal items, and clothing is labeled to prevent errors when laundry is returned. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home receive care from staff who have the skills and knowledge for the work they do. People are protected from the risk of harm by staff recruitment procedures that demonstrate that staff are suitable to work in the home. Evidence: A training manager has recently been appointed who has responsibility for planning and developing the staff training programme. The training manager told us that she is in the process of updating and reviewing all of the policies and procedures for the service, and developing a training programme for staff. The training manager is also developing a new two day induction programme for new staff that will include an induction to care and information about the Mental Capacity Act, the Code of Practice for carers and other information relevant to working in care. Six members of staff have recently completed two days of manual handling training and safeguarding awareness training was completed this week. The staff training matrix demonstrated that training has either been completed or is being planned, to ensure that all staff will have completed basic training in all areas of health and safety and safe working practice. In addition, staff have the opportunity to undertake training in specialist areas of care that are relevant to the needs of the people living in the home, for example, dementia care and specific health conditions, and training in oral health care is planned. Care Homes for Older People Page 22 of 30 Evidence: Thirteen staff have completed training to be appointed first aiders. Ten staff have completed training in mental capacity and how the mental capacity act may affect people who live in the home. Just over 50 of the staff team have achieved an NVQ (National Vocational Qualification) in care, at level, 2, 3 or 4. One person is working towards achieving an NVQ at level 4, currently. The responsible person told us that the policy of the home is for staff to receive formal supervision six times each year, including an annual appraisal. We were told that there has been some slippage in arranging supervision over the last few months, but that this is being addressed and supervision for staff is being arranged by the operations manager. We spoke to two members of staff, one person was new to the home and one person had worked in the home for a number of years. People confirmed that they had received an induction to working in the home and receive training for the work they do. We also received surveys from three staff - comments told us that generally people receive training that is relevant to their work, but two people felt that more could be done to keep staff up to date with new ways of working. Overall, comments from staff indicated satisfaction with working in the home but two people felt that communication and organisation in the home between staff and management could be improved. Two people said that usually there were enough staff on duty to meet the needs of people in the home, but there are occasional shortfalls in the staffing rota if staff are absent. One person felt that a little more supervision for staff would help. We spoke to the responsible person and the operations manager about recent concerns about the organisation of the home. During the temporary absence of the registered manager there have been some occasions when the responsibility for running the home has not been clearly delegated. The problems have been recognised by the responsible person and an interim management plan has been put into place. When we spoke to two members of staff they told us that they thought the new organisational structure was better and felt that the home was better organised. We looked at the recruitment records for three new members of staff; these demonstrated that checks are made before staff start working in the home. This means that people are protected from the risk of harm and staff are suitable to work Care Homes for Older People Page 23 of 30 Evidence: in the home. Care Homes for Older People Page 24 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 home has a suitable management structure in place to ensure that the health, safety and welfare of the residents is promoted and protected. There are systems in place to monitor practice in the home and measure how well the home is providing good outcomes for people living in the home. Evidence: The responsible individual has told us about the interim management arrangements for the home during the temporary absence of the registered manager. Although there was recent concern about lack of clear communication regarding the management arrangements; we saw evidence of prompt and effective action being taken to resolve these concerns. The responsible individual also told us that the service has appointed an head of operations to provide additional operational and organisational support. The home has a number of ways to monitor the quality of the service in the home to ensure that people living in the home receive a service that always meets their needs: the home has almost completed the development of a more comprehensive and Care Homes for Older People Page 25 of 30 Evidence: person centred care planning and review system, a structured staff development and supervision plan is being developed. Regular inspections of the home by the responsible individual or their representative are being carried out; these reports show a more organised and in depth inspection of the home is done with any ongoing action highlighted to be followed up. We received the Annual Quality Assurance Assessment and this provides us with additional information about the home, for example, what improvements and changes have been made as a result of listening to people who use the service. The AQAA told us that new menus have been planned, the main lounge has been divided to create a quiet and private area for residents, a car has been purchased to provide more outings for residents. The refurbishment of the home is ongoing and a new passenger lift has been installed. The AQAA states that a monthly newsletter involving residents is planned so that everyone can see what is going on in the home. The AQAA told us that equality and diversity are promoted in practice in the following ways; by providing opportunities and choices for residents, ensuring that privacy is promoted by having suitable locks on bedrooms doors, encouraging residents to personalise their own rooms with their own belongings, providing residents with access to religious worship, catering for all tastes and choices with menus and food. The service told us that a customer satisfaction questionnaire has been given or sent to residents, family and friends, and professional visitors. Some of the questionnaires have been returned and the comments will be summarised. We were told that the policy of the home is to protect the interests of the residents by ensuring that the home does not act as appointee or be involved in the finances of residents. People manage their own finances or with independent support. We looked at the management of health and safety in the home: a consultant is employed to review all health and safety risk assessments on an annual basis. We also saw evidence of regular checks on fire safety equipment and the fire alarm and emergency lighting to comply with current legislation. The responsible person told us that the kitchen is awaiting major refurbishment. This will affect the residents and we were told that contingency plans will be put into place to ensure that residents continue to receive a choice of meals and snacks during the period of refurbishment. The responsible individual and the training co-ordinator confirmed that staff have Care Homes for Older People Page 26 of 30 Evidence: received training and information about the Mental Capacity Act and how this will affect people living in the home who are unable to make important decisions about their lives. The responsible individual told us the service is aware of deprivation of liberty safeguards and no assessment referrals have been made. Care Homes for Older People Page 27 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 28 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 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 29 of 30 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). 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