Care Home: The Briary Care Home

Similar services:

• St Vincents
• The Cotswold Home
• Winton House
• Rush Court
• Hillyfield Rest Home
• The Maypole Nursing Centre
• The Briars

What the care home does well The home ensured new residents were made to feel welcome and provided useful information about the home including the `Service User Guide` and newsletter. News and views about the home was on the noticeboard at the front entrance for visitors and residents convenience. The home`s AQAA stated that; `on admission a social care profile is completed to help staff understand what interests and hobbies the resident has`. The home made sure that residents health care needs, social interests and family background were assessed and regularly monitored to ensure continuity of care and to assess what opportunities are available for residents to try out new activities. Residents referring to the home said;` I like it here, nice place to live and am happy to be here`. For those residents unable to leave their beds for health reasons the home was committed to including them in appropriate activities designed to relax or provide stimulation. The home was committed to improving the residents` quality of life as was summarised by a relative completing the CQC survey in the section titled; What does the service do well;` treats residents with dignity` and` knows individual preferences, rooms well cared for, keeping me informed of my father`s/mother`s condition`. Residents liked the food that was available and the home made sure that residents were regularly consulted about food choices and organised activities. Regular surveys were completed, meetings were arranged and newsletters published to keep residents and their relatives informed. Meals selected by the residents were routinely assessed by the home before being included in the menu to ensure they were wholesome and nutritionally beneficial. The home made sure that all areas of the home were accessible and secure, clean, tidy and homely. Residents could relax in the conservatory or get some fresh air in the courtyard area and enjoy, a `seaside landscape` that the home had re-created. Photographs of residents and staff around the home helped to promoted a ` homely` atmosphere that residents and staff were keen to foster. Relatives believed that care staff were sensitive and caring and provided a good service to their relatives commenting; ` I have always found staff very helpful and positive`, another commented;` the level/amount of personal care given to my father/mother is appropriate to meet their daily needs (he/she is asked what he/she would like to do for his/herself and what he/she requires help with) it is also provided in a friendly manner`. The home opperated an `open door policy` and encouraged residents and their realatives to comment on how the home was being run. A realtive stated;`I can visit any time which says it all, day or night`. What has improved since the last inspection? There were no requirements made in the last key inspection. What the care home could do better: No requirements were made. All areas of improvement identified during the inspectionhad been completed by the end of the inspection or already listed for improvement by the home in the Annual Quality Assurance Assessment. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Briary Care Home Reading Road North Fleet Hampshire GU51 4AN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Damian Griffiths     Date: 1 2 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: The Briary Care Home Reading Road North Fleet Hampshire GU51 4AN 01252614583 01252812776 briary@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ashbourne (Eton) Limited care home 51 Number of places (if applicable): Under 65 Over 65 0 51 dementia old age, not falling within any other category Additional conditions: 51 0 The maximum number of service users who can be accommodated is: 51 The registered person may provide the following category/ies of service only: 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 categories: Old age, not falling within any other category - OP Dementia - DE Date of last inspection Brief description of the care home The Briary is a large extended house in a pleasant residential area of Fleet and is close to local amenities. The home is registered to provide nursing care for 51 residents in the category of old age or dementia and managed by Southern Cross Healthcare. The home has a large garden and a small secure courtyard garden in the centre of the home. There is car parking at the front of the home. The home has two dining areas, three lounges and a conservatory. There is a mixture of shared and single rooms. Care Homes for Older People Page 4 of 30 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: This unannounced key inspection took place over a seven-hour period. The registered manager Mrs Josephine Kimmance representing the establishment, was available throughout. A tour of the premises was completed , residents care staff and relatives were consulted and CQC surveys distributed. Three surveys were returned from relatives and four were received from care staff. The home had completed and Annual Quality Assurance Assessment (AQAA) prior to the inspection and residents care plans, medication administration records, care staff records, rotas and health and safety records were inspected. The results of this information have been included in this report. Care Homes for Older People Page 6 of 30 Any names and references to those that have been consulted and completed the CQC surveys have been changed in respect to confidentiality. The weekly fees as given at the time of the inspection are £458.32 to £770.00. The fee does not cover items such as hairdressing, chiropody, aromatherapy, newspapers and toiletries. What the care home does well: What has improved since the last inspection? What they could do better: No requirements were made. All areas of improvement identified during the inspection Care Homes for Older People Page 8 of 30 had been completed by the end of the inspection or already listed for improvement by the home in the Annual Quality Assurance Assessment. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. New residents had received a pre admission assessment to ensure that their care needs could be met by the home prior to moving in. Evidence: There was plenty of information available in the entrance hall of the home including the home s Statement of Purpose, information provided by the Southern Cross Organisation, details of the complaints procedures and the latest newsletter. 5 service user care plans were sampled to confirm whether they had received a preadmission care need assessments prior to moving into the home this included two care plans of the most recent of residents joining the home. The homes AQAA stated; if the Briary can meet the needs of prospective residents and the needs of the residents already here, then the manager will assess the resident wishing to come in and ensure that all care needs can be met Care Homes for Older People Page 11 of 30 Evidence: Care staff completing the CQC survey felt confident that they had enough support, experience and knowledge to meet the different needs of the residents who lived at the home. All the residents had received a pre-admission assessment that included details of their family background,contacts,past medical history and other essential areas relating to healthcare and social care needs and interests. Three CQC surveys were completed by relatives on the day of the inspection, one confirmed; the care home provides a safe secure and friendly environment for my father/mother. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care plans were regularly monitored and reviewed ensuring that healthcare needs were met, medication was administered appropriately and residents privacy and dignity was respected. Evidence: A sample of seven care plans were inspected including two of the most recent residents whose care plans were inspected in more detail to confirm the extent of the homes monitoring processes in place. The homes AQAA advised that they had developed a mini care plan in the last 12 monthswe have put many care plans in place, so all care and nursing staff and new staff, are aware of each residents needs and wants. These were available in the residents care plan folders and contained essential details about the residents health and social care needs. For example; healthcare; the resident was diabetic., social care; details of family contacts, life history, food preference, interests and activity preferences. A new residents consulted confirmed that The Briary had been very Care Homes for Older People Page 13 of 30 Evidence: sensitive in collecting information about his/her care needs. The AQAA stated; risk assessments are in place for falls and pressure area care for residents. Areas of risk and care staff intervention were detailed in care plans that had been assessed in areas such as; the use of wheelchairs, hoists and the risk of pressure sores. A record of daily events and various charts monitoring specific areas of risk to residents health were up-to-date. These included monitoring such things as; falls, fluid intake, wound assessment,turning records, personal hygiene and malnutrition screening. This demonstrated how the home was engaged in providing appropriately monitored healthcare and risk assessment to prevent injury. The Medication Administration Records (MAR) of eight residents were inspected to see if they corresponded with prescribed directions. The manager advised that she audited the residents medication needs on a monthly basis to ensure that the MAR were accurate and provided a clear audit trail. All medication was stored in a secure area where a lockable refrigeration unit was available. Details of medication requirements matched those found in residents care plans and appropriate records for controlled drugs and drug returns were in place. All medication was stored in a secure area where a lockable refrigeration unit was available. Details of medication requirements matched those found in residents care plans. Medication administered by staff had been signed using their initials. Specimens of care workers signatures and initials were available for comparison within the MAR. Most medication at the home was dispensed from blister packs ,however a sample of medication required when needed such as painkillers were in the usual packets. These were counted and compared with the MAR. It was noted that medication given to one resident had been incorrectly recorded and totals did not match up with the actual tablets in stock there was a discrepancy of four tablets. It was also difficult to distinguish the signature of the staff administering the medication. This was due to the similarity of the carers initials and the letter N used to indicate medication not taken. This was brought to the managers attention. The manager advised that a monthly medication review would be brought forward and if necessary more training would be made available. There were no further areas of improvement in relation to medication administration identified. A relative completing a CQC survey had written; the amount of personal care given to my mother/father is appropriate to his/her daily needs (they are asked what they would like to do for him/herself and what she/he requires help with). It is also provided in a friendly manner. Care staff were observed addressing residents in the way they preferred using their first names. When administering medication, the nurse waited patiently for a response from the residents with dementia care needs. Care staff observed provided support to residents in a discreet way when necessary as had Care Homes for Older People Page 14 of 30 Evidence: been noted by one of their relatives completing the survey who stated; pulling skirts down over knees. A new resident the home was observed being asked if there were anything she/he needed prior to being given privacy when relatives visited. The manager advised that the home was actively campaigning to improve Dignity in Care. The Southern Cross Times, available to residents, confirmed that this campaign was launched in 2006 by central government. There was evidence in place showing how the home was participating in the nationwide campaign to raise awareness and promote good practice. A comment featured in the CQC survey from a relative confirmed confirmed that the home was doing well in this area stating the home;treats residents with dignity and care staff know (residents) individual preferences. A member of staff was being supported to be a care champion and was involved in train the trainer sessions in order to advise and broaden knowledge in this area of care and demonstrated how the home was implementing good practice and development. Care staff involved were enthusiastic about developing the campaign and looking forward to new ways of introducing positive changes. Care Homes for Older People Page 15 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 provides a variety of activities and provided opportunities to try new things, supporting family, religious and cultural links and providing the daily nutritional needs required to assist in the well-being of the residents. Evidence: The homes AQAA stated; on admission a social care profile is completed to help staff understand what interests and hobbies a resident has and were of the appropriate peer group activities to maintain social and communication living skills. We also document this information on the residents mini care plans. A group of residents who were spoken with confirmed that they routinely met in the lounge area to see what was going on and have a chat and a cup of tea. Residents said they were happy to be here, nice place to live and I like it here and agreed that they enjoyed listening to country and western music that was being played at the time. Other interests of the group were, knitting, relaxing music, manicures and the arts and crafts. There were examples of the residents work displayed on the walls in the hallway. Full details of the residents social and religious interests were available for care staff and residents in their mini care plan and details of the residents daily activities had Care Homes for Older People Page 16 of 30 Evidence: been recorded. The home advised residents in the Statement of Purpose that they had; links with local religious leaders who will visit the care home to meet individual service users and to conduct services or assist service users to engage in prayer. A resident confirmed that he/she was able to attend to their religious beliefs at the home. A relative completing the CQC survey commented in section titled; What could the service do better, more entertainment for residents. Details of recent events and activities were featured in the homes newsletter organised by the new care coordinator. This included; Family Easter celebrations and raffle that had taken place on the 8th April and listed other summer events for 2009 including Residents Tea Parties, with scones and jam and decorated summer hats (a craft project). For those residents unable to participate in group activities the homes activity coordinator advised that they were providing one-to-one support for residents unable to leave their rooms. Activities were chosen in accordance with the residents choice and depended on how well they felt. The co-ordinator advised that activities ranged from; hand massage and reflexology to reading stories, poetry reading and crafts. These were also featured in the homes activities programme prominently displayed on noticeboards throughout the home on a weekly basis. The programme featured symbols below each written activity providing a useful addition to print, for ease of recognition. Evidence of past and present outings had been recorded in the photographs to be found around the home in particular pictures from a recent visit to a farm. The Alzheimers cafe was supported by the home, for all persons with dementia, their families and professionals available every Friday. New activities were in the process of being introduced to appeal to all the senses and was advertised in the , garden plan 2009, to create a herb patch, scented flower area, plants large flower plots and summer bedding. A seaside area had been designed and built in the courtyard of the home to provide fun and an opportunity for some reminiscence therapy. Relatives and friends of residents were supported by the home and were observed visiting throughout the day. A relative of the residents completing the CQC survey commented; I can visit any time, which says it all, day or night. Another commented; They keep me informed of my father/mothers condition. Good practice was observed throughout the day. A member of staff was observed working in a sensitive and knowledgeable way with a resident with dementia care needs, who was insisting that they did not wish to eat their dinner. Care staff acknowledged the residents behaviour but did not intervene. By the time dinner had finished the resident had eaten their dinner and a desert. The care staff advised that Care Homes for Older People Page 17 of 30 Evidence: this was routine behaviour that the resident exhibited and it was important staff followed a plan, which ensured a positive outcome while making sure the resident was comfortable. The homes Service User Guide stated that; we consider it important that you enjoy your meals, not only from the point of view of having a wholesome and nourishing diet, but also with regard to socialising with other service users during mealtimes. We use the Nutmeg menu in the home which is displayed in the diningroom. The Service User Guide detailed the daily mealtime schedule from breakfast to evening drinks served after 8 p.m. Menus could be found displayed on the homes notice boards and the home conducted service user surveys relating to the Nutmeg Menu. This ensured that residents choices were noted and acted upon on a regular basis. A line from the results of the previous survey stated;everyone was happy with the amount of home baking and the fish and chips for Friday lunchtime. A selection of roast dinners, fish, vegetarian and salads were listed including choices for Supper Meals and Deserts including fresh fruit salad,bananas and fresh pineapple. One of the residents consulted confirmed that they liked to have grapes in the evening. A relative completing the CQC survey in the section titled; What to the service do better, claimed that his/her mother/fathers likes and dislikes were not been recorded properly; Ive lost count the number of times the provider has been told about food he/she will not eat, all to no avail.There was evidence in place to show how the home tried to change this. The chef advised that they were currently devising the summer menu and explained the homes process that involved consulting residents and establishing thier likes and dislikes, completing a provisional menu that was referred to the Southern Cross offices where the nutritional value of the meals featured in the residents menu were analysed. The report confirming the nutritional value included mineral/vitamins content was sent back to the home. This ensured that the home was enabling residents to make choices and also being aware of providing food that would maximise residents choice,promote good health, was nutritional and wholesome, however residents were free to change their minds and order what was not on the menu. Care Homes for Older People Page 18 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. The homes residents and their relatives were confident that their complaint would be listened to and acted upon. The home had active safeguarding procedures and policies in place to ensure the health safety and welfare of its residents. Evidence: The homes AQAA indicated that the home was actively engaged in managing a complaints system that was accessible and inclusive to residents, their relatives and advocates. 23 complaints had been recorded in the homes AQAA over the last 12 months. The homes policy document, the Statement of Purpose said;complaints are treated with sensitivity and service users should be able to voice concerns without fear of reprisal. Details of complaints contained in the register showed that the majority of complaints had been resolved within 28 days. The homes complaints register showed a range of complaints clearly demonstrating that residents and their their representatives did not fear reprisal and that they were confident in the knowledge that the home would listen,investigate and act upon its findings. Complaints ranged from; clothes going missing, possessions being lost and rooms that had not been made up. The manager had ensured that each complainant had been suitably addressed and the complaint oucome had been recorded;for example: clothes required labelling, the object lost had been found and the residents room cleaned and new assessories purchased. Care Homes for Older People Page 19 of 30 Evidence: The home exhibited its complaints procedure prominently in the entrance hall next to the visitors signing-in book and relatives/visitors were observed regularly looking at the noticeboard on their way to see the residents. The Statement Purpose and Service User Guide featured; How to Make a Complaint ,listing contact details for the manager, the operations manager, Social Services and contained the correct contact details for CQC. The manager advised that the home was regularly inspected by the operation manager every two months to validate the monthly Home Audit of improvements requiring action. The homes AQAA stated; Regular satisfaction surveys and residents meetings encourage families to let us know if they have a problem. There had been two safeguarding issues reported in the last 12 months in the homes AQAA and following the inspection a third allegation had been instigated. The manager had advised that the previous two safeguarding issues had been investigated jointly with the local authority. There had been no concerns following these investigations reported to CSCI/CQC. The latest allegation was in the process of being investigated at the time of writing this report. The homes AQAA stated that; all staff receive protection of vulnerable adults and abuse awareness training annually. Inspection of personnel files showed that the care staff on duty had received this training. The home ensured that new staff had all received a Protection of Vulnerable Adults first (PoVAfirst) clearance and applied for a full criminal record check. Care staff completing the CQC survey confirmed that they knew what to do if someone had concerns about the home. A resident completing CQC survey stated; the care home provides a safe secure and friendly environment for my father/mother. Care Homes for Older People Page 20 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. The accommodation was comfortable, clean, homely and accessible for all the residents to enjoy, Evidence: A tour of premises was conducted at the beginning of the inspection and residents consulted. The homes garden areas were well maintained and secure for the residents to enjoy. The lawned areas were surrounded by flowerbeds that had been regularly attended. There was room for residents to entertain their relatives and friends and the home had organised regular garden party events. Residents were observed enjoying the comfort of a conservatory that led on to an accessible and safe courtyard area that was only accessible from the main building. It was noted that some of the roof fittings to the conservatory roof had worked loose and required attention this was completed before the end of the inspection. The home had created a seaside environment in one of the corners of the courtyard complete with sand, sea shells and a seaside mural following consultation with the residents and relatives. The courtyard contained benches for residents comfort and tubs of flowers and vegetables provided an interesting,comfortable and fun place to be which all residents could enjoy in safety. Care Homes for Older People Page 21 of 30 Evidence: During the tour a number of areas were observed in need of improvement due to general wear and tear of which the details had been noted in the AQAA. This included corridors and bedroom doors that were in constant use however as a result of the homes system of monthly audits the home had recorded improvements needed in its its maintenance records book. This had been signed by the manager and the operations manager. There was a slight malodour in one of the areas of the home that the manager advised was in need of new carpeting. The source of the malodour was thoroughly cleaned during the inspection rectifying the problem. The home contain a number of rooms that were shared by residents each room can be separated by a curtain when privacy was required. The residents bedrooms each contained personal items that been selected by them and represented individual interests and tastes. The communal lounge areas, bathrooms and toilets and sluice areas were clean and tidy. Paper towels and liquid soap was available where necessary and the homes laundry contained equipment capable of meeting the needs of the residents. The housekeeper employed to ensure that residents clothes were properly cared for had made sure that they were kept separate and reduced the incidence of loss by ensuring that clothes were properly labelled. In order to prevent the occasional loss because of clothes not being labelled a marker pen was always available. Care Homes for Older People Page 22 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. The skill mix of care staff ensured the residents care needs were met, as did the range of training available and the robust recruitment procedures in use. Evidence: CQC surveys were completed by care staff. The surveys revealed that care staff agreed that their employer had carried out checks such as of their CRB and references before they started work. That they all experienced an induction programme that mostly covered all the relevant subject areas. Care staff completing the CQC survey were split between agreeing that there were usually enough staff , and that there were enough staff sometimes to meet residents needs. The homes Statement Purpose provided residents and their relatives with details of staffing arrangements at the home. It indicated that the number of qualified nursing staff were 14, of whom 12 were Registered General Nurses (RGNs) and 2 Registered Mental Nurses (RMNs) who are supported by 27 care staff of whom 4 were senior care assistants. Inspection of the staffing rota over a three month period showed the home provided a consistent number of care/nursing staff to ensure the welfare of the residents was being met. National Vocational Qualifications (NVQs) had been obtained by over 50 of care staff Care Homes for Older People Page 23 of 30 Evidence: at the home and a induction programme ensured that new care staff to the home were aware of the homes policies and procedures , and attained basic training including; mandatory health and safety and safeguarding training. Recruitment procedures were consistent and contained the relevant documentation needed to ensure that staff were suitable to work and support the residents. 7 personnel files sampled contained the required documentation. This included; two references, passport and other suitable ID, job application form with named referees and the appropriate PoVA and criminal record clearance from the Criminal Records Bureau (CRB). It was noted in the documentation provided that some care staff had not received a CRB. The manager advised that these were all new care staff who were currently supervised by senior personnel until their CRB was received. A rota was available to confirm this, showing details of new care staff being supervised by named senior members of staff that matched the duty rotas. Care staff at the home received a selection of training that was relevant to meeting the care needs of the residents. The home ensured that a training matrix was followed by all staff. This was confirmed in the homes AQAA; we have 13 First Aid Appointed persons and 6 Fire Marshals. It went on to say that; mandatory training continues with, fire, infection control, health and safety, food and hygiene, safeguarding adults, moving and handling. Personnel files contained certificates of the training received confirming this statement. The CQC surveys revealed that 3 out of 4 care staff considered that manager support could be better because they met only sometimes to discuss how things were working. One commented; staff come and go because most of the time they cant get support from the superiors. The homes AQAA recognised there were issues around this area,stating in the section titled;What we could do better; Improve planning times for staff appraisals would go some way to improving areas of training and supervision. 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 manager promoted and open door policy and residents and their relatives were encouraged to participate in the running of the home. Monies belonging to residents was carefully managed as was health and safety at the home. Evidence: The registered manager had completed a very detailed AQAA prior to the inspection. It detailed the managers nine years of experience at The Briary and completion of the Registered Manager Award (RMA) in 2004. A City and Guilds Train the Trainer course and a DipHe in Teaching and Assessing in practice. The manager advised that she has a open door policy in place and advised that she encourages residents,relatives and care staff to discuss any issues as they occur however a regular time had been set Care Homes for Older People Page 25 of 30 Evidence: aside and advertised on the noticeboard to ensure that care residents, relatives and care staff could guaranteed a time to meet with the manager. The AQAA confirmed The Operations Manager visits monthly to complete regulation 26 and offer support to the manager. The Home Managers Monthly Care Centre Audit was available for inspection and showed how the manager documented what needed to be done around the home. Sections titled; Home presentation, exterior of building, medication audit, new admissions, review of pressure ulcers, accidents, complaints, personnel files, health and safety, privacy and dignity and staff supervision and communication had been audited at the beginning of the month. The operations manager was present on the lead inspection and confirmed that she visited every two months to assist the manager and audit reports. There were no overall concerns about the way the home was being run on the day of the inspection. Care staff met were willing to discuss their daily role and were enthusiastic and sensitive to the care needs of the residents. Call bells rang throughout the inspection but were attended to within a reasonable time. Residents consulted stated that they; like it here and that they were happy to be here. The home was actively promoting dignity and rights of the residents and one of the relatives comments seemed to sum this up by commenting; treat residents with dignity, keep me informed of my mother/fathers condition, knows individuals preferences and room well cared for. Comments received in section of the CQC survey titled; What does the home do well; the level of care in the home is excellent. the care given to the residents is very good. most of the staff are very caring and are dedicated to the residents and the care they deliver. patient care outstanding. The homes practice of regular consultation with residents, their relatives and their commitment to good communication was evident in the way that there was plentiful information provided in the form of; Statement of Purpose and Service User Guide containing useful information about how the home is run , who it is run by and who to complain to. Other forms of consultation and communication evidenced were; the residents meals survey and the nutmeg menue programme, residents and relatives meetings were advertised on a noticeboard and residents personally confirmed that Care Homes for Older People Page 26 of 30 Evidence: the Briary was a nice place to live . Residents and their relatives also received the Southern Cross Times that gave details of all the different homes owned by the organisation including details of the Dignity in Care campaign. The home had a system of money management for the convenience of its residents who were able to store their monies within a personal aggregate account . The care home did not profit from this and ensured that residents money was recorded and monthly bank accounts were regularly credited. Receipts were kept and a systematic account and invoice process ensured that an accurate monetary record were easily audited. The home followed an active health and safety program ensuring that all new staff were instructed about the health and safety policies and practices. Regular health and safety-related training had been received by all care staff including first aid and infection control. Records of risk assessments for equipment including bedrail,profile beds and water temperatures were regularly updated. There were no health and safety concerns witnessed during the tour of the premises. 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 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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