Care Home: The Corner House

Similar services:

• Claremont House
• Oak Ridge
• Sun Court Nursing Home
• Ashville House
• Bilney Hall
• Hill Barn
• Mabbs Hall Nursing Home
• Henrietta House

What the care home does well Information given to prospective residents was good and helped them make choices about their admission. The process of admission included a thorough assessment process that ensured that the home was clear about the individuals needs and that the service had capacity to meet these. This ensures that admissions are well planned and that the resident can be confident that the home will meet their needs. The care planning documentation introduced at the last inspection in 2007 had been embedded into the way in which the home understood residents daily routine, and provided staff with a good understanding of how they should support the individual during their day. The staff complete care plans that set out instructions for staff in meeting people`s needs. There is a greater emphasis on the resident as a whole in both the care plans and the staffs recording of the resident`s daily lives. The development of this tool is ongoing and the manager and staff demonstrated a good understanding of how the quality of information could be improved to benefit residents and staff in delivering care although some suggestions were made to enhance this further. The service offers individualised support to residents and encourages independence and the development of personal life skills in comfortable, homely surroundings. The residents spoken with were proud of the home and the way of life it provided them with and appreciated the choices in how they spent their day and the opportunities for activity and stimulation. The service has a particularly good relationship with Help the Aged, that has benefited the service in supporting residents social and emotional needs, through befriending services, contribution to large scale entertainment, and other ongoing initiatives. The drive and commitment of the registered manager was apparent in this initiative and in other aspects of the development of a high quality service. The premises are generally clean and homely. They provide a comfortable environment for the people living there. People are able to personalise their rooms. The service maintains and reviews all policies and procedures in a clear, tidy format that are easily accessed and readily available. Other required documents are also well stored and maintained. What has improved since the last inspection? The suggested improvements made at the thematic inspection in 2007 had all been addressed at this inspection. There were no requirements or recommendations made at the home`s previous inspection and the home does not have any requirements made at this inspection. What the care home could do better: Some minor issues relating to the development of good practice in care planning, risk assessment and medication recording were raised with the manager at the inspection. One of the issues had been addressed immediately and the inspector is satisfied that the manager has a good understanding of how care planning, risk assessment in particular to bed rails and medication recording with reference to transcribed medications would be able to address and resolve these issues. No requirements were made at this inspection and only two recommendations were made. Key inspection report Care homes for older people Name: Address: The Corner House 67/69 Wash Lane Clacton On Sea Essex CO15 1DB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Helen Laker     Date: 0 3 0 3 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 31 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 31 Information about the care home Name of care home: Address: The Corner House 67/69 Wash Lane Clacton On Sea Essex CO15 1DB 01255432415 01255474120 cornerhousecare@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Madan Lal Jagota,Mr Sanjay Jagota,Mr Rahul Jagota Name of registered manager (if applicable) Ms Thalia Gaskell Type of registration: Number of places registered: care home 57 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: One person, aged 65 years and over, who requires care by reason of dementia, whose name was made known to the Commission in April 2006 Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 57 persons) The total number of service users accommodated in the home must not exceed 57 persons Date of last inspection Brief description of the care home The Corner House is a care home for older people located in a residential area of Clacton-on-sea. The home is close to the seafront promenade and within walking distance of the town centre shops. There is an established older part to the home and Care Homes for Older People Page 4 of 31 Over 65 1 57 0 0 Brief description of the care home a new extension. Overall the home can accommodate 57 people over the age of 65 years of age. The majority of the rooms are for single occupancy, with five potential double rooms; most rooms have en-suite facilities. Bedrooms are located on the ground and first floors with access to the first floor by a passenger lift or stairs. There are two dining areas and five lounges in total. The home has well-maintained gardens, which are laid to lawn with shrub borders. Parking is available at the front and side of the property as well as unrestricted parking on the street outside. The weekly charge as quoted at this inspection range between 510.00 pounds and 600.00 pounds per week. Additional charges to residents include hairdressing, newspapers, chiropody and toiletries. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this home is three star. This means that people who use this service experience excellent quality outcomes. This key unannounced inspection looking at the core standards for care of older people and took place on a weekday between 10:00 and 16:00. The proprietor, registered manager and staff were available on the day of inspection and assisted with the inspection process by supplying records and information. This report has been compiled using information available prior to the visit such as surveys sent out, evidence found on the day of inspection and the annual quality assurance assessment (AQAA), which is required by law and is a self assessment completed by the service. The AQAA provides an opportunity for the service to tell us what they do well and areas they are looking to improve and/or develop. It is anticipated that some progress be noted as this contributes to the inspection process and indicates the homes understanding of current requirements, legislation changes and own audited compliance. This document will be referred to as the AQAA throughout the report. This inspection looked at the quality of information Care Homes for Older People Page 6 of 31 given to people about the care home and whether people experience open and fair conditions of care. The findings of that inspection have been incorporated into this report along with any updated information in respect of the issues considered. During the day the care plans and files for five of the residents were seen as well as four staff files, the policy folders, the medication administration records (MAR sheets), some maintenance records and the fire log. The manager also supplied a copy of the duty rota, the menus, and other pertinent documentation which was required. A tour of the Corner House was undertaken and eight residents and six members of staff were spoken with. The home was clean and tidy offering homely accommodation to the resident. The residents seen were relaxed and clearly felt at home in the environment using all areas of the building. All the records and files were well maintained and easily accessible. Interactions between staff and residents were friendly and appropriate. Feedback on findings was given during the visit with the opportunity for discussion or clarification. The inspector would like to thank the proprietor, manager, staff team, residents, relatives and visiting professionals for their help throughout the inspection process. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: Some minor issues relating to the development of good practice in care planning, risk assessment and medication recording were raised with the manager at the inspection. One of the issues had been addressed immediately and the inspector is satisfied that the manager has a good understanding of how care planning, risk assessment in particular to bed rails and medication recording with reference to transcribed medications would be able to address and resolve these issues. No requirements were made at this inspection and only two recommendations were made. Care Homes for Older People Page 8 of 31 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 31 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 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to this service. Prospective residents are informed about the service and can be confident that the staff will understand their needs and abilities. Evidence: At the homes last inspection in January 2007 it was noted that the home has a preadmission assessment system in place. The assessment documentation completed goes on to form part of the care plan. This inspection carried out at the home in March 2010 looked in detail at the arrangements made to inform prospective residents about the home, and the way in which the service gathered information about the individuals needs prior to their agreement to provide accommodation. The home provides a comprehensive package of information for prospective service users and every service user receives a copy of the Service User guide, which is available in a large print version. The Service User Guide clearly sets out what is Care Homes for Older People Page 11 of 31 Evidence: provided by the home. The assessments of four recent admissions to the home since the last inspection were inspected. All the assessments seen were noted to have been completed prior to the admission date and cover the required areas. These had been completed well. Sufficient detail was clear relating to the physical and social side of care needs required individually, with good family and social histories being in place. Information on residents personal preferences and their daily routines was also included. Evidence of family involvement was noted. The AQAA submitted states We encourage and make arrangements for prospective service users to have a trial afternoon or meal in the home where at all possible, thus they can then have the chance to talk with current residents and get a taste of the environment we offer. If this is not possible we carry photos and information to them when the assessment is carried out, for example when an individual is in hospital but can not visit the home. Prior to admission all residents under go a full assessment that identifies their needs and medical history. The assessment also includes information about their social interests, hobbies, religious and cultural needs. It also determines any special provision or arrangements that need to be in place prior to admission, e.g district nurses referrals with regards to pressure care or wound management. Service users are informed about our trial period of four weeks, at admission. We encourage families to take their time in assisting the resident to settle into their room and offer them to partake of meals at the home where appropriate. Every resident has a full care plan which identifies their needs and uses risk assessments to identify and manage risks to achieve outcomes that are conducive to promoting independence and maintaining their safety at all times. Information seen in the assessments reviewed did tally with the actual care plan. On admission the staff generally complete an admission checklist to ensure that all areas are covered and this has been re developed to be more person centred and an individual process for the new resident with additional paperwork now being in place. Service users spoken with on the day of the inspection visit all said that arrangements for moving into the home had generally been made by relatives. Relatives spoken with on the day of the inspection all confirmed that they had visited the home and received all the information they needed. Discussions with the manager and residents at this visit also confirmed that residents felt that they had been well informed about the home and how it operates, and had been given opportunity to visit prior to moving in wherever possible. All the residents spoken with felt that whatever the circumstances of their admission to the home, it had been a positive move. Records examined all contained contracts between the service user and the home, signed by either the service user or a relative on their behalf. Contracts examined appeared fair and are written reasonably well in plain English, and the document now benefits from having the paragraphs numbered to make referencing easier. Care Homes for Older People Page 12 of 31 Evidence: The inspection also considered how assessment of the individuals needs was carried out prior to their admission. The records examined show assessments remain good, as at previous inspections. Service users and relatives spoken with confirm that social services carry out an assessment and the home manager visits and also carries out a comprehensive assessment of needs. Plans of care are developed from the assessments and there is evidence of family involvement in the contracts and assessment reviews. All service users spoken with confirmed that they were consulted about their care needs. The home does not provide intermediate care. Care Homes for Older People Page 13 of 31 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. This judgement has been made using available evidence including a visit to this service. Residents can be confident that staff will understand how to best support them in their daily lives. They can be assured that their health care needs will be met and they are supported to access health professionals as needed. Evidence: The support and documentation of five residents was considered at this inspection in order to understand how the service understands the way in which it should meet their needs. The documents contained in the care plans of these residents contained a comprehensive variety of assessments that identified the level of support the individual required in their daily lives. The files also contained two documents that described the residents daily living preferences for day and night. The daytime sheet was broken up into time zones of early, mid morning, midday etc and in each section the preferred routine of the individual was written in a person centred way, identifying their abilities to maintain their independence first with staff intervention being the final part of the statement. Although the sheets described in some detail the way in which Care Homes for Older People Page 14 of 31 Evidence: staff should expect to approach the support of the individual, they did not fully reflect the information contained in the assessments. For example a resident who required assistance with mobility in one assessment, was seen to be independent with their mobility in another which consisted of a tick box system. The importance of the correlation and consistency of the care plan was discussed with the manager who agreed that some areas were confusing and required much more specific detail so that service users individual needs can be understood and met. Additionally it was noted there was a make a difference to my day assessment which included what sort of tone of voice to use , how to rouse or approach someone and talked about the individuals wishes and aims for the day. Pen pictures are also in place and the AQAA states The life histories that are in place allow care staff to have an insight into the wishes of service users and so treat them with greater respect and dignity. The inspector was able to discuss the way in which the documents were used with the Registered Manager and identified the development required to provide a comprehensive instruction to staff in meeting the individuals needs. The Registered Manager agreed that the revised documents which had been developed following discussions with staff about the way in which they used the care planning tools in existence, had highlighted that they were not fulfilling their function in developing a consistent approach to care provision in the service. A number of residents who required bed rails were noted to not have protective bumpers in place and essential risk assessment documentation was not in place. Upon noting this observation protective bed rail bumpers were ordered by the proprietor on the day of inspection and we were assured that each service user requiring them would be appropriately risk assessed and documentation included in their plan of care as a matter of priority. The health care of residents was monitored through the documents contained in care plans, these included health professional visits, and their outcomes, monitoring sheets for weight, diet etc. Residents generally visit their GP at the surgery wherever possible accompanied by a member of staff. Medication is kept in locked cabinets in locked cupboards spread around the home to provide adequate storage for the size of home. All medication is delivered in monitored dosage system provided by Care Home Meds, apart from PRN (as required) medication. MAR sheets are used to monitor incoming and outgoing medications. Controlled drugs are kept in locked cabinets attached to the wall in each cupboard. Controlled drugs logs are kept for these drugs with two signatures for dispensing. Some residents self medicate and a risk assessment is carried out that includes initial regular monitoring of their capabilities, with periodic monitoring and audit of drug stocks at the end of each month. Discussions with staff indicated they understood practice and were able to demonstrate a sound knowledge of medication process. Photographs were seen in the medication folder of each person and records were found to be in general good order. Medication Administration Records (MAR) sheets were neat but there were some hand written / transcribed Care Homes for Older People Page 15 of 31 Evidence: medication entries without two signatures. A signature audit may be of value to keep this issue in check. Staff need to make better use of the omissions code. The majority of residents spoken with and surveyed were very satisfied with the standards of care and said that they received the care and support they needed. It was evident from discussions with residents that staff did try to provide person centred care. They confirmed that staff respected their privacy and dignity whilst providing care. One resident described the care staff as Very caring, loyal and never have to complain about care needs not being met Two relatives spoken with both agreed that management and staff met the care needs of their relative well and they received the medical support they required and had no complaints. During the inspection we were able to observe staff going about their duties and as they approached and spoke with the people living at Corner House, it was observed that they were both respectful and sensitive to the peoples needs and there was lots of friendly chatting and joking going on between staff and residents. Staff approach to privacy is good and relatives confirmed this on the day. Interaction between staff and residents was seen and heard to be friendly, caring and respectful. The care plan files examined during the inspection all contained reference to the residents preferences in respect of terminal illness and following their death. This information will enable staff to ensure that they are adhering to the individuals wishes even at a difficult and emotional time when such enquiries would be unsuitable if not noted previously. Care Homes for Older People Page 16 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to this service. Residents living at Corner House are able to make choices about their lifestyles and the social, cultural and recreational activities meet their expectations. Evidence: The opportunities for activity and occupation are varied at the home, and this is provided both by staff employed at the service and through their links with other agencies such as help the aged. The organisation demonstrates their commitment to activity as part of the residents daily lives through the allocation of a monthly budget provided to the manager specifically for the funding of events. Funds are also raised through donations and raffles. The service employs an activities co ordinator who is a keen organiser and assists the manager to identify how the budget should be allocated and organises the equipment and resources needed. There is an activity rota posted prominently in the home and the recommendations made at previous inspections in relation to the eye catching format have been responded to. The notice advertises the weekly bingo and manicure sessions facilitated by the activities coordinator as well as events with entertainers Care Homes for Older People Page 17 of 31 Evidence: and outside facilitators. Photos of events are on display and a monthly newsletter is developed. The home enjoys a strong association with the local branch of the Help the Aged charity organisation. The relationship has fostered a number of initiatives to benefit both the residents living at the home and encourage the local community to engage with the service. This has included the invitation to local people to visit the home as volunteer befrienders. The volunteers are from varied age groups and backgrounds, and include for example mothers with children and schools who also visit and speak with residents. The home is also in the process of piloting a telephone befriending scheme (which is a good idea for those residents who cannot leave the home or their rooms) and IT mentoring to assist residents to have contact with external friends and family via other methods. Another successful idea previously has been through the connections with local schools and the setting up of living history discussions. Pupils from the school visit residents and ask them to relate their life experiences, which are recorded onto Compact disc. The young people benefit from the insight into past lives and a real history lesson, whilst residents enjoy the involvement with young people and the value their recollections are given. The residents are presented with the CD as a memento of their involvement. Further initiatives are being developed and help the aged is looking at how they can continue to enhance the lives of residents through occupation and activity, and hold afternoon tea parties with residents to discuss this further. Residents said the additional opportunities to go out and to take part in routines of daily life would be welcome. Although the charity is responsible for the operation of the projects, it was clear from speaking with their representative and the manager that it is the homes commitment and enthusiasm for their involvement that has made the experience work. In fact similar initiatives in other homes locally have failed principally due to the lack of support from the homes. The visitors policy is open and residents and their supporters are encouraged to access the home as they wish. Facilities such as a visitors lounge with dining seating are provided to allow residents to invite their visitors to meals. Residents relatives are encouraged to not only visit the home but to take residents out wherever possible. The residents who spoke with the inspector gave examples of where they felt they were offered opportunity to exercise choice in their daily lives. They began with the way in which their room was decorated, and they informed the inspector that they had been able to choose the colour of their room and bring with them any items they wished from home. They felt that in their daily life they are able to chose what time they got up, and in some cases who got them up if they objected to male carers. They chose where they spend their time and could come and go from the home, as they Care Homes for Older People Page 18 of 31 Evidence: preferred. This experience was reiterated in discussions with staff, who clearly understood that the arrangements for the day were fitted around residents choices and not timetabled to fit the staff. This was evidenced in their descriptions of their typical day that all reflected responding to individuals needs and wishes. A discussion with the homes activities co ordinator highlighted an activities log that is kept. Activities include a Wii, karaoke, knitting, gardening, small household tasks and Trying to bring the outside in. For example in the summer sand was taken into residents rooms to enable them to make sandcastles and a real ice cream van was pulled up outside the home to enhance the idea of being in a beach environment. Also tentatively planned for Easter is the possible hatching of real chicks, and return to their home, but this is yet to be confirmed. One seagull is a regular visitor to the home and is fed by one resident and her family. The home has previously been the winner of innovation and good practice category from the Community Sunshine project run by Essex County Council. The home has also been filmed by NAPA for a promotional DVD. The AQAA states We are looking to recruit further volunteers to assisit with I.T. mentoring and to help run activities in the home. We are running open days at the home to show the wider community how they can become involved in the home and how our residents can be active members of their local community. We are planning to hold an International Day where we celebrate the diversity of our residents and staff and try foods and activities from around the world. We will then run themed days through the coming year. We plan to fundraise for Red Nose Day and Lennox Childrens charities this year. With the employment of our project coordianator we have been able to increase the range of activities we have on offer through out the week. with outings taking place also. Residents spoken with confirmed that there was a wide range of activities staing We can choose what to do and The gardens are kept nice and well mantained. One event observed was that of bingo which proved extremely popular with seats having to be sourced from other areas in the home as it was very well attended on the day of inspection. The menu on offer to residents is varied and offers opportunity for choice at main meals. The breakfast is served in a buffet style with residents being offered a choice of cereals etc as they come down to the dining room in the morning. Residents can also chose where they eat their meals and regular preferences are recorded in care plans. One service user who has a special diet commented They do their best with my food but I have it bland so can cause some difficulties sometimes Some residents said at the last inspection that the evening meal quality varied and felt this was an area where the home could make improvements. Comments at this inspection indicated that improvements had been made and that there were generally no complaints where the food was concerned. Care Homes for Older People Page 19 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to this service. The service is proactive in ensuring that residents rights are upheld and concerns are listened to. Procedures in the home ensure people living there can be confident that they are protected from abuse. Evidence: On the day of the inspection visit the homes complaints procedure was examined. The document contains appropriate information to ensure service users or other interested parties know what to do if they need to make a complaint, including timescales for response and contact details for the Care Quality Commission (CQC). The manager confirmed that there is a copy of the complaints procedure in every service users room. Service users spoken with are all confident they would know what to do if they wished to raise a concern or make a complaint. Relatives spoken with also confirmed that they are certain that any concerns would be dealt with promptly. Complaint records examined at this inspection showed that the most recent complaints had all been dealt with appropriately. The AQAA states All complaints are given careful consideration and are acted on promptly. The complaints procedure is followed and the policy is displayed in the home and in each service user guide given to a resident at admission. All staff have a POVA First check and CRB (Criminal Records Bureau) check on file. Any allegations of abuse are dealt with promptly and all actions recorded and advice Care Homes for Older People Page 20 of 31 Evidence: from the safeguarding unit sought. At this inspection the residents were asked for their views on the homes complaints procedures and their experiences. They continue to feel confident in speaking with the senior staff of the home, and that their views would be listened to and action would be taken. The service has a policy and procedure for dealing with the Protection of Vulnerable Adults. This includes how staff are recruited to the home and the checks that the service undertakes and also the training staff receive in understanding abuse and their responsibilities if witnessing abusive actions. The policy is appropriate to current local guidance in reporting abuse. Staff spoken with were confident about their ability to recognise abuse and what responsibilities and protection whistle blowing affords them. They also confirmed that they had completed SOVA training in June 2009 and certification for this was seen. We were also informed by the manager on the day of inspection that they had introduced a new updated safeguarding policy and procedure, that advises staff on the correct action and reporting process in the case of suspected abuse or safeguarding incident. There is now a safeguarding log for recording all incidents. As part of the complaints procedure and manager Supervision, the proprietors now review and sign off all complaints received periodically. The home had reported one safeguarding incident in the previous twelve months and this was appropriately dealt with by the service and bought to a satisfactory conclusion. The home has consistently shown they consider it a priority that residents rights to protection are supported. Care Homes for Older People Page 21 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to this service. Residents are provided with premises that support independence, choice and dignity. Evidence: The premises are presented and maintained to a high standard with a variety of communal space available for residents to use, including a total of four lounges and two dining rooms. One lounge was used as a quiet area for residents who wished to have some privacy with visitors. One of the lounges also had a kitchenette and tea and coffee making facilities so that residents and their visitors could have refreshments whenever they wanted. New crockery has recently been purchased for this area. The bedrooms are mainly single and provide adequate space for the recommended furnishing including armchairs. The rooms were pleasantly laid out with low windows to enable residents to see out when seated, and had been personalised with residents choice of decor and belongings. Residents spoken with during the inspection were very proud of the home and the way it was presented. One resident said It is very clean and it isnt home but it is very close as they are all like a family here another commented They are always improving things and if you need something done or fixed they just do it. The providers and manager are proactive in maintaining the appearance of the premises and ensure that any opportunity to benefit the service is seized. They keep themselves updated on developments in the Care Homes for Older People Page 22 of 31 Evidence: care industry and have previously applied for government improvement grants and have been successful. This is an initiative aimed to assist care homes to make improvements to premises to benefit residents. Following a previous consultation with residents and their families to identify what they felt money could be spent on, The application focused on an underused lounge by providing additional facilities such as a large screen television with surround sound, a computer and a bar to provide an entertainment room. Additionally the garden leading from this lounge was to be provided with a Gazebo and new outdoor furniture. The AQAA submitted advises us The passenger lift, has been updated to offer better opening doors for ease of use for our independent service users. Two new boilers have been fitted to better supply the middle section of the home with heating and hot water. These boilers are space saving and more environmentally friendly. We have laid non slip wipeable flooring to our main dinning room and upstairs lounge, this offers a more hygienic and suitable surface for the activities we run in these areas. The main dinning room has also been redecorated in a warm colour and new curtains fitted. The kitchen floor has also been replaced and is better fit for this busy area and for infection control now. and future planned improvements include A green house is on order and will both offer gardening activities for our service users and also provide the home with bad weather storage for more delicate plants we intend to buy. We have made arrangements for the outside of the building to be painted and weather protected and will be purchasing a big screen TV and a Lap Top for our non mobile residents. We are also informed that a memorial seat is being developed in the garden and the front reception area is due to be redecorated and given a face lift to make it more welcoming and homely. Communal areas were light and spacious with comfortable furnishings with no noticeable odours. Overall the impression is of a homely environment where people are comfortable. Care Homes for Older People Page 23 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to this service. The residents feel supported by the numbers of staff and the skills they hold. Robust recruitment measures ensure residents are protected wherever possible. Evidence: The manager confirmed that the residential forum is used to calculate staffing numbers and the rota examined provided evidence of a flexible and supportive staffing arrangement. Staff spoken with felt that their day was not rushed and that there was adequate staff numbers to support the residents needs, and did not feel they were working to a stopwatch. Throughout the inspection visit the atmosphere was calm and peaceful with none of the hectic movements associated with activities such as toileting and mealtimes. Residents also commented that they did not feel rushed at any time of the day, they were given time to get up and did not feel that staff were overly stretched. The home has not employed any agency staff to fill vacant hours using the existing staff group to cover instead. The AQAA submitted states We maintain high levels of staff on duty in the home. And staff are skilled and trained in all roles with in the home. We encourage all staff to undertake a NVQ relevant to their role and actively seek training opportunities from a number of sources. All staff undergo a 16 week Care Homes for Older People Page 24 of 31 Evidence: probationary period and their performance is reviewed and supervised reguarly. We offer a variety of employment roles and shifts, so that we have a diverse and flexible workforce. Four staff files reviewed contained evidence of the robust home recruitment procedures and included application forms with employment history, proof of identity, two written references and CRB checks. Discussions with staff confirmed that the service operates a robust system of recruitment that protects residents. The manager also confirmed I spoke with service users about what they felt where important qualties that I should be looking for at interview, and I now have two service users who assist me in interviewing perspective applicants. I have implimented an more in depth induction for all new staff. Staff training is a high priority in the service and commencing at the induction of new staff against Skills for Care standards staff are provided with ongoing development. A rolling programme of training includes SOVA, infection control, moving and handling, basic diabetes awareness, blood glucose monitoring and malnutrition screening. A few staff had also been trained to an advanced level in diabetes awareness and were certified to administer insulin with District Nurses retaining overall responsibility. The NVQ training for staff is ongoing and at the time of the inspection visit over 50 per cent of the work force held NVQ level 2 or above. The home is also part of a training consortium with three other homes and training courses include moving and handling, basic food hygiene, Fire, Health and Safety, SOVA, First Aid and infection control. Staff spoken with during the inspection were appreciative of the training on offer and felt this reflected the services value of them as team members. One member of staff said that although they had worked in other care services for a number of years they had been provided with more opportunity to attend courses since working at Corner House than in all their previous employment. Care Homes for Older People Page 25 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to this service. Residents benefit from a committed management team, who listen to their views and respond to improve the service. Residents can be confident that the home is run in their best interests and it ensures their safety and welfare. Evidence: The home does have a registered manager. The manager currently in post has held the post since May 2008. The AQAA informs us that The home is managed by a competent team, Home Manager, Deputy Manager and Admin Manager, with the involvement of the registered providers/owners. The management team hold and are undertaking relevant qualfications specific to their job roles. The registered manager holds the Registered Managers Award (NVQ level 4 in management. She confirmed that she did feel supported in her role and that staff had supported her and that they all worked well together. The management of the service is respected by staff and residents and discussions with the inspector all referred to her evident leadership and Care Homes for Older People Page 26 of 31 Evidence: the confidence this provided to both staff and residents. Residents are proud of the home and the way in which it was operated, comments such as it is like staying with friends and I feel sorry for people that dont live in a home like this gave an indication of their strength of feeling. A quality assurance system is operated in the home with questionnaires provided to residents, relatives, and health and social care professionals and staff. The results are audited and used to produce a business plan for the coming year, a copy of which is provided to the CQC. Additionally meetings are held with all levels of staff and residents from which minutes are published. The proprietors have introduced a monthly quality assurance system, in which they review and record both positive and negative occurrences/outcomes that affect the residents and families, staff, maintenance and vacancies, this also includes supervision of the manager. A further improvement is that the manager reviews all accident records, district nurse referrals, and district nurses case load and record both postive and negative findings on a monthly audit. The management structure has also been improved. A few changes include, the administration manager is now trained as a trainer in Common Induction Standards and has completed NVQ Level 3 in Business and Administration and the Activities Co-Ordinator has completed the Train the Trainer Course in First Aid. The home is also one of the homes piloting the My Home Life philosophy in Essex, run by Help the Aged. They are involved in research and providing feedback of the implementation of this programme and its ethos. The proprietors are representives for care homes in the Essex County Council Strategy Group for new ideas & improvements. The strategy meetings are chaired by the scheme and we are furthered informed that the manager will continue for a further year on the Managers Development and Action Learning Group with My Home Life scheme along with other home managers across Essex. The service manages a small amount of residents personal funds on the behalf of individuals. This is kept in a safe, and individual account balance sheets are maintained along with their cash. The balance sheets demonstrate money received and spent on behalf of residents with dated entries containing descriptions of expenditure, amounts spent and two signatures. In general the receipts relating to the expenditure are attached, however in a small number of cases the residents financial affairs are managed by a third party such as a solicitor or relative and in these cases the receipts are returned to them. The manager provides copies of receipts to the third party and retains the originals with the balance sheets. Staff files contained copies of line management supervision and individual development plans. The supervision records demonstrated that staff receive regular feedback on their performance as well as an opportunity to add to their personal development plan by identifying training to support them. Staff spoken with during the inspection felt the sessions were beneficial to their practice and development. Records relating to the maintenance of equipment and health and safety requirements were considered at this inspection. These included documentation such Care Homes for Older People Page 27 of 31 Evidence: as certificates for gas, electric, fire records, hoist and lift maintenance. These documents were present and in date for their annual checks. Care Homes for Older People Page 28 of 31 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 29 of 31 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 1 9 Appropriate risk assessments should be in place for those service user using bedrails to ensure they are protected and kept safe from harm. Any transcribed medications must be clearly documented with evidence of two signatures to ensure the risk of medication errors being made are reduced. 2 10 Care Homes for Older People Page 30 of 31 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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