Care Home: The Croft Residential Home

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What the care home does well People have ample opportunity to learn about what the home offers before they decide it is right for them . Thorough assessments are made of people before they are offered a place so the home knows it can meet their needs. There are clear care plans that tell staff what care and support people need. These are reviewed and amended regularly and as people`s needs change. People receive good personal care and the home monitors and addresses their health needs well in cooperation with local health professionals. The systems for helping people with their medicines is well managed. People are well supported to enjoy their daily lives and social activities. They particularly like the food. Particular attention is paid to maintaining contact with people who are important to people living in the home. This extends to providing support emotional and practical support. People`s concerns and complaints are listened to and acted upon. Staff know what to do if they suspect any abuse. The Croft provides a clean, homely and well maintained home for people. There are good standards of hygiene and infection control. People living in the home are supported by sufficient numbers of well trained staff who meet their needs and provide individual attention People benefit from a home that is well managed with an excellent ethos of care and support. What has improved since the last inspection? Since our last visit, the home has completed an extension and upgraded some facilities. The number of places has increase from 14 to 22. What the care home could do better: The home should review the arrangements for hairdressing which presently invade the privacy of individuals living in the home. Key inspection report Care homes for older people Name: Address: The Croft Residential Home 22 College Road The Croft Newton Abbot Devon TQ12 1EG     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: Graham Thomas     Date: 3 0 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: The Croft Residential Home 22 College Road The Croft Newton Abbot Devon TQ12 1EG 01626207265 01626207265 thecroftresidentialhome@blueyonder.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Cheryl Ann Howe care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accomodated is 22 The registered person may provide the following category of service only: Care Home only - Code PC to service users of either gender whose primary care needs on admission are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) Date of last inspection Brief description of the care home The Croft is a detatched period property with a modern extension set in a quiet residential area on the outskirts of Newton Abbot. Care and support is provided for up to 22 older people who may have a diagnosis of dementia. The home is at the top of a steep drive with some parking spaces outside the building. Further parking is available on the road outside the home. A recent extension has been completed to provide eight new bedrooms, new day rooms and two new assisted bathrooms. Other bedrooms have also been upgraded. In all, accommodation is arranged over three floors with Care Homes for Older People Page 4 of 27 22 0 Over 65 0 22 Brief description of the care home both a shaft lift and stair lift to the upper areas. There are sixteen single and three shared rooms, most of which have en-suite facilities. There are three commuanl lounges and a separate dining area as well as gardens to the rear. Information about the home is available to visitors. Weekly fees currently range from £322 to £456 Care Homes for Older People Page 5 of 27 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: Before we visited the home we reviewed our records. This included any complaints we had received and what other people had told us about the home. We also looked at information the home had sent us about incidents. These are called notifications. Six people living in the home and two staff completed surveys we had sent them. Two relatives wrote to us about their experience of the home. We visited the home with an Expert by Experience from Help the Aged. and spent a day there. An Expert by Experience is a person who has experience and knowledge of the specific kinds of services we inspect and who provides an independent view. During our visit we spoke with people living in the home, the staff and the manager. We looked around and saw staff at work. The Expert by Experience joined people for lunch and looked particularly at how the home supports people to enjoy their daily lives and social activities. Care Homes for Older People Page 6 of 27 We looked at a number of records including care plans, staff files and other records about the running of the home. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 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. Standards 2, 3 and 6 People considering moving into The Croft receive plenty of information to help them decide if it is right for them. There is an sensitive assessment and admission process which takes account of the needs of the family as well as those of the person moving in. Evidence: In the Annual Quality Assurance Assessment returned to us before our visit, the home told us that initial assessment information is gathered over as many visits to the person as necessary as well as other professional resources. We looked at the information made available to people about the home. A statement of purpose and service users guide are available to people who might be considering The Croft as a future home. Six people who live there returned surveys to us. All but one stated that they had received enough information about the home to help them Care Homes for Older People Page 10 of 27 Evidence: decide if it was right for them to move in. The other person wrote, My two sons visited other homes for me and felt this was the best. All six said that they had received written information about the homes terms and conditions. Mrs Howe told us that the homes approach to admissions was holistic and took account of the support needs of the family as well as the person coming to live in the home. This was borne out by comments we received from relatives. One relative wrote to us and told us about her mothers admission to the home. She stated, Cheryl was so welcoming, approachable and understanding. .....She offered a home visit to mum the very next day. She and her Care Manager gave a very thorough evaluation and offered mum a place immediately One of the planned developments the home described in its Annual Quality assurance Questionnaire was To start a family support group were past and present families can sit once a month and discuss their feelings worries and access support so they dont feel so alone. During our visit we found evidence of a structured process of assessment to ensure the home could meet peoples needs before they move in. In the file of one person who had moved in recently we saw detailed notes made during three visits to the persons home over a period of four weeks. People we spoke with during our visit to the home told us they had the opportunity to visit The Croft and spend time there before they decided to move in. The Manager told us the home had spent six weeks working with a family and the person prior to a recent admission. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 7, 8, 9 and 10 The home offers an excellent standard of care and support to people living there. Evidence: Six surveys were returned to us by people living at the Croft. They had completed these themselves or with help from relatives or supporters. They told us that they received the care and medical support they need. They also stated that there were always or usually staff on hand when needed who would listen to them and act on what they said. One person commented that The Croft take pride in the welfare of the residents. A relative commented that the Croft is A very caring place and I am pleased that my mother is living in such a lovely place We looked in detail at the plans of three people and how their care was being managed. The plans contained detailed information about each person including their personal, health care,social and psychological needs. Each part of the plan had a specific objective and described how care should be provided. The plans were reviewed monthly and provided detailed information about peoples needs such as Care Homes for Older People Page 12 of 27 Evidence: nutrition, continence, oral and foot care and medication. Risk assessments were contained in the plans concerning both personal and environmental risks such as the use of the garden, falls, pressure areas and activities. We noted during our tour that people were well groomed and clean. People told the Expert by Experience that they were pleased with the laundry arrangements We looked at how the home supported people to maintain good health. Each plan contained notes of hospital visits and appointments with health professionals such as general practitioners, opticians podiatrists. In one plan we saw that the person was being supported to follow a high calorie diet. Arrangements for the persons meals were confirmed by staff working in the kitchen. In two plans we saw how peoples mental health was being monitored and promoted. This included, for example, regular monitoring of mood and encouragement to participate in activities. We also saw regular bathing records that showed the date, time, water temperature, weight and general observations. Body maps were seen in individual files for recording any bruises, skin breakdown and so on. The homes system for helping people with medicines was examined. We found that all medication was securely stored. Medicines are stored in two secure medication trolleys which are chained to a wall when not in use. Additional secure storage is provided for controlled drugs where there is also a refrigerator for medicines requiring cool storage. The home uses a monitored dosage system in which most tablets are sorted into separate doses in blister packs by the pharmacy. The records relating to these and other medicines in use were up to date and in good order. We saw evidence that medication had been reviewed and modified where necessary. All the interactions we saw between staff and people using the home were supportive, respectful and relaxed. We saw that staff knocked on peoples doors before entering their rooms and that personal care giving was provided behind closed doors. During our visit, the hairdresser was using one persons room as a salon. Although none of those concerned appeared to mind, this does represent an invasion of one persons privacy and excluded the person temporarily from her room. In one plan we saw correspondence from relatives that showed how the home had worked closely with a persons family and health professionals to provide suitable end of life care. As this persons needs had increased, the usual monthly reviews had increased in response to changes in the persons condition. Before our visit to the home a relative wrote to us to tell us about the return of her mother to The Croft Care Homes for Older People Page 13 of 27 Evidence: following hospital admission after a stroke. She said that ...on the day of discharge we visited mum back at The Croft where she was now in a downstairs room but already all her possessions had been relocated and even her pictures hung on the wall.... The very next day mum was up and dressed and eating thickened drinks and eating pureed food.....During the last few days Cheryl was happy for me to stay overnight and with mum and I observe first hand the care, attention and affection given to mum and the family also. Another relative commented favourably about the extended support and care offered to his wife and others in the family: ...... my wife suffered a major seizure resulting in emergency services being called and being taken to A&E. Given that this was on a Sunday, Mrs Howe personally took time out of her family life and met with my two daughters at the hospital in order to support the family as a whole. Later that evening Mrs Howe and one of the other carers yet again returned and sat and fed my wife, as at this stage in her world, The Croft are now more familiar to her and they wanted to offer continuity of care as well as support my children. Care Homes for Older People Page 14 of 27 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. Standards 12, 13, 14 and 15 The Croft offers a high standard of person-centred support for people to enjoy their daily lives and keep in contact with those who are important to them. Evidence: We looked at how people were supported to enjoy their daily lives and social activities. The six people who returned surveys to us told us that there were always activities people could take part in if they wished. The Expert by Experience wrote As there is no dedicated Activities Organiser the responsibility for delivering activities is undertaken by various members of staff and outsiders. The residents were not able to say much about the activities but in the morning seemed to enjoy the 1940s music being played from a CD in the main lounge with several people singing along. A couple of people referred to trips out and the photographs on display depicted residents in a hired minibus on outings to Totnes, Dart Valley Railway and Widdicombe In The Moor. Other places visited included the resorts of Teignmouth and Dawlish. Various entertainers visit on a very regular basis providing people with a variety of Care Homes for Older People Page 15 of 27 Evidence: musical opportunities. Skittles and Memory Lane are also a regular feature. One person mentioned enjoying Aromatherapy and in particular the foot bath and another recalled sewing and embroidery sessions......The activities appear to be tailored to the abilities of the residents with due regard to mental and physical state..... ....A lady is taken to the Salvation Army service on Sundays and arrangements are in hand for visits by various clergy on demand. Another lady said, If I needed something in the town I am sure a carer would accompany me... ...People were of the opinion that they chose their own time of retiring and rising. Two people recalled, We sometimes stay up late to watch a film. Some residents choose to have breakfast in bed or in their bedroom with others electing to eat in one of the two dining rooms. At lunchtime the meal was served in both dining rooms and in bedrooms as requested by residents..... ....Residents were very complimentary about the food saying, Food is excellent, No complaints about the food, I enjoy the food, The food is good, I always look forward to having my food and The food is very good. On the day of the visit the lunch was roast turkey with stuffing, cranberry sauce, roast potatoes, cabbage, carrots, cauliflower and broad beans. The meal was suitably hot and looked appetising - it also tasted good. The dessert was a choice of rice pudding or pineapple slices and ice cream. Three diners ate in the first floor dining room and conversation flowed. In the main dining room carers assisted the diners in an appropriate manner. Soft diets were catered for. Snacks and main meals from the freezer are available 24/7 for those unable to sleep in the night. The availability of meals at night was confirmed by staff who have all received training in food hygiene. Frozen prepared meals were seen in the homes freezer for this purpose. Mrs Howe explained that she felt it important that people with dementia should be supported to follow their own routine, even if this did not conform to usual expectations. As described in previous sections of this report, particular attention is paid to supporting the family members of people who live in the home. One Relative wrote: There is a 24 hours open door policy for relatives and I feel this is important knowing that I and my wifes family can visit unannounced at any time. Care Homes for Older People Page 16 of 27 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. Standards 16 and 18 People living at The Croft can feel confident that their concerns and complaints will be listened to and acted upon. There are robust systems in place to protect people from abuse. Evidence: We looked at how the home deals with complaints and concerns. The home has a complaints procedure which we saw on display in the hall. This contained details of how to contact the Care Quality Commission and the local authority. Our records show that we have received no complaints about The Croft since we last visited in 2007. The homes own complaints record showed there had been no complaints. All six people who returned surveys to us said that they knew how to make a formal complaint. They also told us that there is someone they could speak with informally if they were not happy. One relative commented that they felt ... any matter arising would be dealt with appropriately During our visit, one person told us about a minor concern they had raised concerning cleanliness of a toilet. They told us that this had been dealt with promptly and that there had never been a recurrence of their concern. Staff training records showed ongoing training concerning the safeguarding of Care Homes for Older People Page 17 of 27 Evidence: vulnerable people from abuse. We spoke with the homes staff who were clear about what might constitute abuse, how they would report it and what outside agencies they could contact if necessary. The availability of external advocacy is maintained by membership of CARE AWARE Care Homes for Older People Page 18 of 27 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. Standards 19 and 26 The Croft provides a pleasant, homely clean and hygienic home for the people living there. Evidence: The Croft is a detatched period property with a modern extension set in a quiet residential area on the outskirts of Newton Abbot. The home is at the top of a steep drive with some parking spaces outside the building. Further parking is available on the road outside the home. Since our last visit, the extension has been completed to provide eight new bedrooms, new day rooms and two new assisted bathrooms. Other bedrooms have also been upgraded. In all, accommodation is arranged over three floors with both a shaft lift and stair lift to the upper areas. There are sixteen single and three shared rooms, most of which have en-suite facilities. In surveys returned to us before our visit, everyone told us that the home is always fresh and clean. One person commented that their ...room is very comfortable with a comfortable bed, and chair, toilet etc In a letter one relative stated that The Croft was ...homely with lovely decor, furnishings and with so much light coming in through the large windows. One person felt that the layout of the home was confusing. During our tour we saw Care Homes for Older People Page 19 of 27 Evidence: signs with pictures on doors and discussed with the provider how people are assisted to find their way around. The Expert by experience wrote: During the summer, advantage can be taken of the several outdoor seating areas where good rural views and the wildlife can be enjoyed. One resident recalled taking tea on the decking. Ice cream is also said to be served in the garden in good weather. There is a Quiet lounge and a main lounge on the ground floor and a further lounge on the first floor. These two latter rooms have televisions and an ample supply of videos and DVDs. There is also a small library. All the rooms have comfortable furniture and are freshly and attractively decorated. Most of the bedrooms visited have been personalised to a greater or lesser degree by the occupant and/or their families. A couple of rooms occupied by gents had bare walls and were devoid of memorabilia...The heating and lighting were good and there were no unpleasant odours. Throughout the premises the maintenance, decoration and carpeting were excellent. During our visit we saw clear records of planned and completed maintenance. We looked at the measures in place to maintain hygiene and control infection. During our tour we noted a high standard of cleanliness in all areas. We noted that mops and buckets were colour coded for use in different areas. In shared toilets and bathrooms there was liquid soap, paper towels and gloves available for personal care. The homes laundry is sited in the basement away from food preparation areas. This had been equipped with a new washing machine with appropriate hot wash cycles and two new dryers. Soluble red bags were in use for contaminated laundry. Care Homes for Older People Page 20 of 27 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. Standards 27, 28, 29 and 30 People living at The Croft are supported by staff who are safely recruited and well trained. Evidence: Our inspection visit was undertaken in a busy period between Christmas and the New Year. Domestic and cooking staff were on leave. However, we saw that there were enough staff to meet individual needs and provide individual attention. The Expert by Experience reported: As far as could be seen the carers had the knowledge, skill and desire to assist their charges to lead as normal a life as was possible. A resident said, The staff are super here, they never have an off day and there is never a turmoil day. Whilst the staff were busy they did seem to have time to stop and engage with residents as they went about their tasks. We received many positive comments about staff both before and during our visit. Of the six people who returned surveys to us, five people stated that staff were always available when needed and the other stated that this was usually the case. One relative commented I have full confidence that the level of care, staff, food prepared and provided and hygiene is outstanding Another remarked All the staff at the Croft Care Homes for Older People Page 21 of 27 Evidence: were so friendly and caring....Cheryl and her staff took exceptional care of mum during her final two weeks of life. Rotas showed that there were sufficient care staff on duty at all times who are supported by domestic and cooking staff. Two waking night staff were shown on the homes rota. We looked at the file of a recently recruited member of staff. This showed that a recruitment procedure was in place that provided thorough checks of peoples suitability to work with vulnerable adults. This included a formal application, criminal records checks, a full employment history and confirmation of identity. Discussions with Mrs Howe and staff as well as examination of staffing records revealed a strong commitment to staff training and development. In the AQAA returned to us by the home before our visit, they told us The home takes staff training very seriously and employs a training company that has introduced a training matrix that currently holds 14 courses all of which are dealing with every area of care...This continues to grow as staff become more interested in stretching their skills and looking at new ideas that will improve the quality of life our clients have by giving my staff the skills to do this..The home is also pro-active in N.V.Q. in care. At the time of our visit, one staff member was working through her induction training which appeared thorough and was based on a nationally recognised framework. In individual files we saw evidence of training in health and safety topics such as moving and handling, fire safety and food hygiene. There was also evidence of training relating to the needs of people using the service. This included, for example, dementia care and nutrition. Two staff were about to undertake management training so that they could participate more fully in the management tasks of the home. Staff commented favourably on the training. One staff member told us that although her first aid certificate was valid for three years, a course was taken annually. Care Homes for Older People Page 22 of 27 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. Standards 31, 32 33, 35, 36 and 38 People living at the Croft can feel confident that the home is very well run for their benefit. Evidence: Cheryl Howe is both a registered provider of the service and the Registered Manager. She has had many years experience of working in care and has gained the Registered Managers Award and a National Vocational Qualification in care at level 4.. She also is qualified in first aid and has attended courses relevant to the needs of people living in the home such as dementia and palliative care. Feedback we received from relatives, staff and people using the service indicated a strong ethos of support for people living in the home which extended to their families and carers. This was perceived as a particular area of strength. One relative commented: Care Homes for Older People Page 23 of 27 Evidence: I shall be forever thankful to the Croft for making mums time in residential care so comfortable and stressless. I would, and have, recommended the Croft to friends in similar circumstances with elderly parents Staff described the support from Mrs Howe as amazing and brilliant. They confirmed our findings in the homes records of regular supervision and appraisal. One staff member said that could talk to the manager at any time and that unplanned supervision was available if required. Throughout this inspection, we saw evidence of a commitment to ongoing improvement. This was evident in recent upgrading and refurbishment of the homes environment, surveys sent to people with an interest in the home and the homes development of its staff. We discussed with the manager how peoples financial interests were safeguarded. Mrs Howe confirmed that the home does not involve itself in peoples individual finances as these are managed by peoples relatives or other representatives. We looked at how health and safety is managed in the home. We found that the staff training programme included health and safety topics such as fire safety, first aid and food hygiene. One member of staff confirmed that the first aid training she received exceeded the recommended frequency. The home employs the services of an independent company to conduct risk assessments and has addressed the issues identified. These risk assessments included, for instance, hazardous substances, moving and handling objects and the work of a pregnant staff member. Files we examined contained evidence of a recent gas safety check, boiler servicing and a stair lift maintenance contract. The Expert by Experience commented, The overall impression was that The Croft is a well-managed, clean and caring establishment where the foremost priority is the well being of the residents. Care Homes for Older People Page 24 of 27 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 25 of 27 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 10 Arrangements for hairdressing should ensure that peoples privacy and access to their rooms are not disrupted. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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