Care Home: The Elms

Similar services:

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

What the care home does well The home provides a relaxed, comfortable and friendly atmosphere where people are treated with respect and in a dignified way. The home makes every effort to provide people with good care to meet their assessed needs following a care plan. The home has a good key worker system and staff supervision system in place. The home communicates well with the families, friends and representatives of people who use the service and welcomes visitors. People who use the service say they are happy and content with living in a homely and caring place. The comments we received via on-site surveys included: "The service does all it does to the best of their ability. This applies to all and everything that is done in the home. Care has always been at the highest level". "I find all the services very well done". People who use the service are often vulnerable both physically and emotionally and the Registered Providers and the Registered Manager ensure that staff recruited have the ability to carry out personal care services for people sensitively and tactfully. The recruitment of good caring staff is critical to the running of care homes and the Registered Providers and the Registered Manager at The Elms undertake this carefully. The home has a good staff training and development programme in place. A majority of staff have received mandatory training in safe working practice topics, Dementia care, safe handling of medication, Adult Protection and safeguarding issues and National Vocational Qualification (NVQ) Level 2. Thus this training will ensure that the staff have improved their knowledge and skills to meet the changing needs of people who use the service. The home provides good standard of accommodation and facilities for people using the service. What has improved since the last inspection? People commented that: "Lots of recent improvements to decor and fittings etc. I am impressed with the freshness and cleanliness". "The facilities and the care provided by management and staff is much better than previous years". The home has an experienced Registered Manager in post and she is managing the care home well. Conversations with staff, people using the service and their visiting relatives, indicated that the Registered Manager is service user focused, leads and supports an enhanced staff team providing them with improved training and supervision. This style and approach to management aims to pursue future improvements in all aspects of service. One person who lives at the home stated that "This place is a lot more peaceful and better organised now. I am happy living here". The home has made some good improvements in their record keeping and care planning. Care Plans seen for people who use the service were informative and gave good indication of how care is to be delivered for each of them. Medication practices have improved and more senior staff have received training in safe handling of medication. The home has organised staff training on Dementia care. A majority of staff have received training in safe working practice topics, abuse awareness and adultprotection and that will enable them to expand their knowledge and skills and enhance the care they give to people using the service. What the care home could do better: The home should continue to improve further the detail and quality of daily care recordings. Those members of staff who as yet have not received training in safe working practice topics, including infection control, safe handling of medication, Dementia care, NVQ Level 2, Adult Protection and safeguarding issues must do so as a matter of priority. This training would enable staff to improve further their care practices, knowledge and skills. The AQAA submitted prior to this visit by the Registered Manager stated that "We will continue with the annual reviews of policies, documents, maintenance of equipment and update where necessary. We will complete new care plans very shortly. Staff have embraced the change of our registration to include service users with Dementia. They are finding the challenge very rewarding and wish to expand their knowledge by undertaking more training and continue working with our care plans". Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Elms 13 Regent Street Bilston Wolverhampton West Midlands WV14 6AH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Bhag Jassal     Date: 3 0 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: The Elms 13 Regent Street Bilston Wolverhampton West Midlands WV14 6AH 01902491890 01902408875 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Charn Kaur Surae,Mr Jagjit Singh Surae care home 13 Number of places (if applicable): Under 65 Over 65 0 13 dementia old age, not falling within any other category Additional conditions: 13 0 The maximum number of service users who can be accommodated is 13. The registered person may provide the following category of service only: Care home only - Code PC; to service users of the following gender: Either; whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP (maximum number of places 13); Dementia - Code DE (maximum number of places 13). Date of last inspection Brief description of the care home The Elms is a large detached property situated in a residential area of Bilston. The home is currently registered for 13 older people with Dementia care by the jointowners Mr and Mrs Surae. There are eleven single bedrooms, four of these with ensuite facilities and one double bedroom. The home has an adequate garden and car park space at the rear of the building. There are adequate number of bathrooms/showers and WCs. There is a lounge and a dining room. There is also a Care Homes for Older People Page 4 of 29 Brief description of the care home conservatory which was built in 2008. The kitchen is fully equipped. There is a laundry room. The Home is in close proximity to all of the local amenities, which includes the health, leisure and community centres, a park, a library, shops and a market and access to public transport i.e. buses and Metro. At the time of this inspection the weekly fees for care ranged from a minimum £400.00 per week up-to a maximum of £430.00. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 Star. This means the people who use the service experience good quality outcomes. This report is on a Key Inspection, part of which included an unannounced visit undertaken on 30th March 2009. This unannounced visit started at 09:25 and lasted 7 hours and 30 minutes. The home had all 13 places occupied. The judgements made within this report are based upon information supplied by the home, from interviews with staff, people who use the service and their relatives. During the course of inspection the assessment information, care and care plans were case tracked for 3 people who use the service. Medication administration was checked. Care Homes for Older People Page 6 of 29 Staff records were seen to check staff rotas, recruitment procedures and training. Various documents were seen in order to check compliance with health and safety legislation. A tour of premises was also undertaken, and care practices and interaction between staff and people who use the service were observed. Discussions took place with several members of staff on duty, and several people using the service and two visiting relatives were spoken to throughout the day of inspection. The Registered Manager - Mrs Susan Nelhams was present throughout the Inspection. Mrs Charn Kaur Surae - Responsible Individual was also present briefly in the late afternoon. On this occasion all the key Standards of the National Minimum Standards were assessed - that is those areas of service delivery that are considered essential to the running of a care home. Regulation 37 Notifications, concerns and complaints against the home, and Regulation 26 reports received from the care home and an Annual Quality Assurance Assessment (AQAA), which had been completed by the Registered Manager and submitted to the Commission for Social Care Inspection (CSCI) prior to this inspection, offering a full overview of the home were considered and discussed with the Registered Manager. Prior to this inspection an AQAA document was sent to the home for completion. The AQAA is a self - assessment and a dataset that is filled in once a year by all Registered Providers. It informs us about how Registered Providers are meeting outcomes for people using their service and is an opportunity for Registered Providers to share with us areas that they believe they are doing well. It is a legal requirement that the AQAA is completed. The Elms returned their completed AQAA to CSCI within the given timescale. Information within this document demonstrates that the Registered Manager and the Registered Providers recognises the strengths and weaknesses within the service and are able to plan for improvement. The AQAA provided information to supplement the inspection. We wish to thank the Registered Manager, the Registered Providers, the staff, people using the service and their relatives for their assistance and co-operation on the day of inspection. What the care home does well: What has improved since the last inspection? People commented that: Lots of recent improvements to decor and fittings etc. I am impressed with the freshness and cleanliness. The facilities and the care provided by management and staff is much better than previous years. The home has an experienced Registered Manager in post and she is managing the care home well. Conversations with staff, people using the service and their visiting relatives, indicated that the Registered Manager is service user focused, leads and supports an enhanced staff team providing them with improved training and supervision. This style and approach to management aims to pursue future improvements in all aspects of service. One person who lives at the home stated that This place is a lot more peaceful and better organised now. I am happy living here. The home has made some good improvements in their record keeping and care planning. Care Plans seen for people who use the service were informative and gave good indication of how care is to be delivered for each of them. Medication practices have improved and more senior staff have received training in safe handling of medication. The home has organised staff training on Dementia care. A majority of staff have received training in safe working practice topics, abuse awareness and adult Care Homes for Older People Page 8 of 29 protection and that will enable them to expand their knowledge and skills and enhance the care they give to people using the service. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Everyone receives a full assessment prior to admission to the home to make sure that their care needs can be met. Evidence: The Elms - care home provides detailed and clear information, in the form of a Service Users Guide, to people who will be using the service and their families to enable them to make decisions about whether or not to live at the home. Admissions are not made to the care home until a full assessment has been undertaken. The home is then able to confirm that they can meet the needs of the individual through the service they deliver as detailed in the Statement of Purpose. For people who are self - funding and without a care management assessment, they always receive assessment by the Registered Manager. 3 files/care plans of people who use the service were inspected, which contained pre Care Homes for Older People Page 11 of 29 Evidence: admission assessments of their needs, both from assessments by the homes senior staff and other relevant professionals. One of the completed Surveys returned to us stated that before moving to the home We were given a tour of the home and told about all the care and help that is available. Observations and discussions with people using the service, their visiting relatives, the Registered Manager, and staff on duty indicated that the home continues to meet the needs of older people in a satisfactory and sensitive manner. It was noted from the staff training records that a majority of staff have undertaken their training in Dementia care and adult protection and safeguarding issues. The home does not provide a service for those assessed and referred solely for intermediate care, who require help to maximise their independence and return home. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have individual plans of care, which ensures that their personal, healthcare and social needs can be met. Medication is administered and stored in a manner that safeguards everyone using the service. People who use the service are treated with respect and dignity and their right to privacy is understood and upheld. Evidence: People who use the service undergo an assessment of their needs prior to admission to the care home. A Care Plan is produced, which is based on the assessment of needs. The home operates a good key worker system, which helps to ensure that the recommendations arising from the care plan reviews are implemented. Three Care Plans of people using the service were inspected and examined in detail. There was evidence to show that the short - term goals and long - term goals, aims and objectives were clearly identified and appropriate interventions required to meet the individual needs of people who use the service were also identified. The Registered Manager stated that the care plans are being updated and infomation has been Care Homes for Older People Page 13 of 29 Evidence: transferred on to new care plan format for several people who use the service and the remaining care plans to be completed by the end of April 2009. The detail and quality of daily care recording also will be undertaken by care staff and they will be closely supervised and supported to achieve this. Discussion with people who use the service showed that the home has a good ethos of involving them in all aspects of their life. The care plans that were read were clearly written and included an element of risk assessment. Information from the initial assessments had been written into plans of care. The care plans are reviewed on a monthly basis by senior staff. Care Plans demonstrated that the staff actively promoted the rights of people who use the service of access to the health services both within the home and the community. Appointments are planned or arrangements are made for professionals to visit frail people using the service. Whenever possible continuity of care for the declining state of health of people who use the service is assured. District Nurses are called upon to assist with clinical help, equipment and advice where necessary. The Registered Manager promotes the key worker system so that relationships between staff and individuals are enhanced. Visitors are able to meet people using the service in their bedrooms, in the lounge or conservatory on the ground floor. It was observed that people who use the service were being treated with respect and staff were working both professionally and sensitively in meeting individual needs. We spoke at length with several people using the service and all of them commented positively about their care and felt they have everything that they need. Four people who use the service stated that The carers are very good and kind and they look after us very well. Two other people who use the service said The carers are always there to help us. Generally people who use the service appeared to be content and comfortable. They were complimentary regarding the quality of their lives and care they were receiving at The Elms - care home. One of the relatives stated in the returned survey that My mother is very happy and content here. She gets on well with staff. There are appropriate policies and procedures in place for the administration of medication. It was noted that the care plans contained a list of current medication. The Registered Manager stated that reviews are carried out on a regular basis of all the care plans to ensure that medication details are up to date. Appropriate records are kept of all medicines received, administered and leaving the home. Random sample of medication and administration sheets were seen at the inspection and there were no discrepancies. All the medicines are stored in the mobile medication trolley which is kept under lock and key and chained to wall after use. Daily checks are taken of the temperature of the medicines in the refrigerator. Care Homes for Older People Page 14 of 29 Evidence: There are no controlled drugs used at present by any service user at the care home. However, if there is a need to store such drugs securely and safely in a lockable metal cupboard, which is available in the Registered Managers office. Medication rounds were observed during the inspection. Senior staff were seen to administer and record when medicines had been given. The Registered Manager stated that all senior staff responsible for administering medication were appropriately trained in safe handling of medication. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to exercise choice with regard to social and leisure activities at the home. Activities provided meet the needs of the people using the service. Relatives and friends are encouraged and assisted to maintain contact with the people using the service. The food at the home is of good quality and choices are always available. Evidence: The home provides an activities programme in accordance with everyone using the service, their choices, preferences and capacities in relation to - social, leisure and cultural interests. People using the service, who were able to give opinion, were very complimentary about the activities provided, and particularly the external entertainers. People who use the service are enabled to enjoy a full and stimulating life style with a variety of options to choose from. A record of activities participated in is kept and photographs of major events displayed in the home. People using the service were seen sitting in the lounge and conservatory chatting to staff and visiting relatives and in other communal areas within the home. Two people who use the service stated that they preferred to sometimes sit quietly in their bedrooms and the staff respected this. After lunch time a number of people who use the service were engaged in playing Care Homes for Older People Page 16 of 29 Evidence: different games or watching television. The homes AQAA states The home organises entertainment delivered by external entertainers, for example, craftwork, music and exercise. There have been several outings i.e. a musical at the local theatre and Walsall Lights. The home also organises different activities on a daily basis, which include quiz, sing a long, song and dance, reminiscence, bingo, old time music and person centred chats. Several people using the service spoken to stated that they were in regular contact with their family members and friends, and spoke about their visitors involvement and interest in their care matters. The visitors book kept in the home showed a considerable activity. People who use the service also keep contacts with the local community - for example, church services, pubs, shops and park. Five people who use the service told us that they are happy with the care and social activities offered by the care home. They further added The home provides a good service and the staff are very caring and they are pleasant. The home also provides a variety of indoor activities, including festive and birthday parties. The Registered Manager stated that the people who use the service were positively encouraged and helped to exercise their choices, and control over their lives and daily living, subject to risk assessments in terms of safety, security and capacity to make certain decisions. The Registered Manager also stated that a close liaison is maintained with the relatives and representatives, where the people using the service are not able to make certain decisions. The relatives of people using the service and their representatives are informed of the availability of Advocacy Service based at the local Age Concern. The information about the Advocacy Service is included in the homes Statement of Purpose and Service Users Guide. Several people who use the service told us The home is very good and its peace and quiet here. The food was very nice well cooked and tasty. The consensus of people using the service was the range, quality and choice of food provided was very good and the home catered for those people using the service, who have individual preferences and medical needs. The Registered Manager stated that the menu is changed regularly in consultation with the people who use the service. This is usually done in accordance with seasonal changes as well. The kitchen is well equipped and kept clean and tidy. The catering staff are trained in food safety and hygiene matters. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is clear Complaints Procedure in place, a copy of which is made available to people who use the service and their relatives. This should ensure that any complaints made are listened to and acted upon. The home has an Adult Protection policy and procedure in place to protect people who use the service from all forms of abuse. Evidence: The home has a good Complaints Procedure in place, which is referred to in the homes Service Users Guide and in the Statement of purpose. There is a system of recording concerns and complaints. The AQAA completed by the Registered Manager states We have a comprehensive complaints procedure and ensure that all people who use the service and their families are aware of how to make a complaint. Our complaints procedure and procedures for dealing with abuse are highlighted in the Service Users Guide, which is issued on admission. The Commission for Social Care Inspection (CSCI) has received one complaint about the care home and there was one adult protection referral made during the last 12 months, which were dealt satisfactorily with through the Wolverhamptons Safeguarding Adults procedures. People, who use the service, when asked, were certain of how to formally make a complaint but they said they would quite happily talk to one of the staff or the Care Homes for Older People Page 18 of 29 Evidence: Manager. The home has good policies and procedures in place regarding restraint, dealing with aggressive behaviour and prevention of abuse, which includes whistle - blowing policy. The Registered Manager stated that adult protection issues are discussed during staff induction training and supervision meetings. The Registered Manager also stated that a majority of staff have received formal training in protection of vulnerable adults and those who as yet have not received this mode of training will do so as a matter of priority. She also stated that trainers are being approached to set up this training. The homes AQAA states that their plans for improvements in the next 12 months are to provide formal training for staff on Deprivation of Liberty, all staff to complete Equality and Diversity training, Mental Capacity Act training for all staff to be completed this year and also all staff to complete training in dealing with challenging behaviour. Several people who use the service stated they are satisfied with the service provision, feel safe and well supported by staff that have their protection and safety as a priority. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment is good providing a homely, clean and secure place to live. Evidence: The home offers a comfortable and well - maintained environment to all people who use the service. The home has ample communal space - a lounge, conservatory and a dining room. The home has a rolling programme of redecoration to maintain good standards. The garden and patio areas are well - maintained. The home has provided suitable aids and adaptations in the home to meet the general and specific needs of all the people using the service. There are adequate numbers of bathrooms/showers and WCs in the home. It was noted that the bedrooms are personalised by most of the people using the service. During the day of inspection, the home was found to be clean, tidy and free from any unpleasant odour. The AQAA completed by the Registered Manager states that, new laminated flooring in the lounge has been provided. A number of bedrooms have been redecorated and several items of furniture, fittings and equipment have been purchases/replaced. The homes AQAA states that the their plans for improvement in the next 12 months Care Homes for Older People Page 20 of 29 Evidence: are to continue with the redecoration programme, to replace flooring in the dining room and chairs in the lounge and in bedrooms. However, during the tour of the premises we noted the following issues :That the hot water supply in a number of bedrooms hot water outlets was noted to be inconsistent and it was either below 38 Degrees C or between 44 Degrees C to 47 Degrees C. This needs rectifying as a matter of priority to ensure the safety of people who use the service. That the self-closure mechanism fitted on several bedroom doors in need of adjusting to ensure that the doors fully close to their rebate. This is to ensure the safety of all people using the service. The home has good policies and procedures in place regarding infection control. At present the home have four people who use the service with MRSA. The Registered Manager stated that the relevant procedures have been implemented and liaison with relevant authorites have been undertaken to deal with this matter. However, it was noted from the staff training records that a majority of staff have undertaken training in infection control and those members of staff who as yet have not received this mode of training will do so shortly and as a matter of priority. It was noted from staff files seen that all new members of staff received induction training and they are made aware of the dangers of cross - infection. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Elms - care home is staffed by well - trained and experienced staff to meet the needs of people who use the service. There are robust recruitment procedures in place to protect people who use the service. There is a good training programme in place that ensures staff are competent to do their jobs. New members of receive structured induction training. Evidence: Information provided by the home and available staff rotas for the month of March 2009 indicated that the home has sufficient care staff to meet the needs of the 13 people who use the service. There is one senior carer or deputy manager and two carers on duty in the morning and one senior carer or deputy manager and two carers in the afternoon shift. Two carers are on wakeful night duty and a senior member of staff on - call. The Registered Managers hours are supernumerary. There are adequate numbers of ancillary staff employed in the home to cover catering, cleaning and maintenance duties throughout the week. However, it was noted that the carers are expected to undertake laundry duties in addition to their caring duties, and also one of the carers on the afternoon shift have to go into the kitchen and prepare and distribute the evening tea. The Registered Manager stated that at present there are two vacant posts of carers (20 hours per Care Homes for Older People Page 22 of 29 Evidence: week each) which are being filled shortly. The staff training records showed that a majority of staff have completed their NVQ Level 2 qualification and five members of staff have also completed their NVQ Level 3 training. The remaining members of staff who as yet have not received this mode of training will also be nominated to undertake this mode of training shortly. Several members of staff are currently undertaking their Palliative Care training. The home does not employ Agency staff. The staff team is a well - balanced group in terms of age, experience, gender and ethnicity. Four staff files were examined in detail in order to check compliance with the recruitment requirements. All four files contained copies of two written references, and a full employment history. There was evidence on staff files that all four had been subject to satisfactory Criminal Records Bureau (CRB) and (Protection of Vulnerable Adults) POVA checks prior to being appointed. There was evidence on files that staff have received the statements of their terms and conditions of employment. There is a staff training and development programme in place. In addition to the mandatory training (see NMS OP38) staff also would benefit from training in adult protection/safeguarding issues, Mental Capacity Act 2005, equality and diversity, and physical aggression/challenging behaviours. Staff confirmed that training is provided and there are many opportunities to improve themselves for the benefit of the care of people using the service. All new staff received their induction training in accordance with the Skills for Care standards and specifications. People who use the service commented that they feel safe with staff caring for them and they felt that the home employs people that are capable of carrying out their care duties. Four members of staff completed our On-site-Surveys and they all were positive about the home and one stated that what the service does well is To keep the service users well being of importance and priority and to have good family encouragement. Another stated The home provides a safe and comfortable environment for the service users, with a very friendly atmosphere. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that the home is run in their interests. Financial interests of people using the service are safeguarded. The home promotes the health, safety and welfare of people who use the service. Evidence: The Elms care home has an experienced and competent Registered Manager who has been in this post since 2005. The Registered Manager - Ms Susan Nelhams has completed her Registered Managers Award and NVQ Level 4 in care qualifications. She appears to be managing the home well. There are clear lines of accountability within the home and the Registered Manager is well supported by the Registered Providers. The home has a formal staff supervision system in place, and Ms Nelhams is implementing the system of supervision of staff and meetings both with staff and people using the service. Observations made and discussions with people who use the service and their relatives Care Homes for Older People Page 24 of 29 Evidence: and staff have indicated that the Registered Manager is very approachable and she operates an open door policy. People who use the service, who could express themselves stated that they are happy to approach the manager and staff with any problems they might have and were confident that they would respond to them appropriately. Equality and diversity for people who use the service were seen to be promoted throughout the home within the assessments, care plans and activities. Equality for staff is promoted through the opportunities for training at all levels. The home has a Quality Assurance monitoring system in place. Quality Assurance takes place throughout the service in both a formal and informal manner. Meetings and day - to -day contacts all provide records to show that satisfaction is at the heart of the service for people who use the service. Surveys for the year 2009 has been carried. A report on the result of the feedback from people who use the service and their relatives will be prepared and made available in the home shortly. In addition, stakeholders survey has also been carried out, but the response has not been forthcoming and the Registered Manager stated that she will contact the respondents again and then their feedback will also be analysed and the report will be made available in the home. The copies of reports of visits made to the service by the Registered Provider under Regulation 26 of the Care Homes Regulations 2001 should be made available in the home and for inspection by the Commission for Social Care Inspection. Financial records and administrative procedures relating to the handling of the monies of people who use the service were looked at and were found to be well ordered and maintained. The home actively encourages people using the service, where able, to manage their own money. The home keeps records to show that health and safety of people who use the service is promoted and protected. It was noted that the hot water supply in several hot water outlets was inconsistent and must be maintained at the recommended level of hot water temperature of close to 43 Degrees C at all times to ensure the safety of people who use the service. Several self - closure devices fitted on the bedroom doors were in need of checking and appropriately adjusting to ensure they close properly to their rebate to protect people using the service from the risks of fire. The Registered Manager stated that this matter will be addressed immediately. The Registered Manager also stated that the issues identified in the Fire Safety Officers inspection report dated 27th June 2008 and the Environmental Health Officers inspection report dated 20th May 2008 have been addressed by the Registered Providers. Care Homes for Older People Page 25 of 29 Evidence: The staff training records showed that a majority of staff have received their mandatory training in safe working practice topics, e.g. moving and handling, food hygiene, first aid, health and safety, infection control and fire safety. The Registered Manager stated that all those members of staff who as yet have not received this mode of training will do so shortly. They will also receive training in Adult Protection/safeguarding issues, safe handling of medication, Infection Control, NVQ Level 2, Mental Capacity Act 2005 and Dementia care. People who use the service spoken with were very complimentary about the Registered Manager and staff in the home. Many of them knew who they were by name and looked at ease in their presence. Care Homes for Older People Page 26 of 29 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 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 It is recommended that the Registered Manager takes appropriate action to further improve the detail and quality of daily care recording in order to ensure that staff are aware of the importance of recording all information regarding the well being of people who use the service, and all the entries made by the staff are always cross referenced to care plans. It is recommended that appropriate action is taken by the Registered providers to address promptly all the essential maintenance and repairs such as those identified in this report. This is to ensure that people who use the service live in a comfortable, secure and safe home. It is recommended that the Registered Providers take appropriate action to ensure that the hot water supply in all the hot water outlets is maintained consistently at the recommended temperature level of close to 43 Degrees C, to ensure safety of people who use the service; and also to ensure that the self - closure machanism fitted to the bedroom doors closes properly to their rebate, to protect and secure the safety of people who use the service at all times. 2 19 3 38 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!