Care Home: The Grove

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What the care home does well The environment is spacious, comfortable, clean and well maintained. Outside there is a large, well-stocked and safe garden that the residents say they enjoy a great deal. The care and support given to residents at the home is excellent. Good relationships are maintained with local health and social care professionals to work together to promote the health and well-being of the residents. There is a wide variety of activities going on. These include visiting entertainers, celebrations of special occasions, one to one activities, arts and crafts, flower arranging, gardening, quizzes and crosswords. Residents say that the food at the home is very good and that they enjoy their meals and have plenty to drink. There is a stable and well trained staff team who work well together and say they love working in the home. The home is well managed and has robust quality assurance processes in place. What has improved since the last inspection? Food services at the home have improved. There is now a greater choice of meals and residents praised the cook for the quality of the meals. The home now has an activities co-ordinator and there is a greater variety of activities on offer to help the residents maintain their independence and to continue to lead interesting and meaningful lives. There have been a number of environmental improvements including a new security lock on the front door and refurbishment of some of the rooms. What the care home could do better: No requirements or recommendations were placed as a result of this inspection. Key inspection report Care homes for older people Name: Address: The Grove Bower Mount Road Maidstone Kent ME16 8AU     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: Wendy Mills     Date: 0 1 0 4 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 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) © 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 27 Information about the care home Name of care home: Address: The Grove Bower Mount Road Maidstone Kent ME16 8AU 01622755292 01622755292 thegroverh@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Smartblade Limited Name of registered manager (if applicable) Rosemary Anne Lee Type of registration: Number of places registered: care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 32 The registered person may provide the following category of service: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home The Grove is a residential care home providing personal care and support for up to thirty-two older people. It is situated in a quiet residential area near the centre of the county town of Maidstone in Kent. There are good road and public transport links. The A 20 and M20 are easlily accessed and there is a regular bus route that runs along the main road a short walk from the home. Maidstone has two railway stations, one is within approximately ten minutes walking distance, the other is a short bus ride away. Care Homes for Older People Page 4 of 27 Over 65 32 0 Brief description of the care home The property is a large house set in attractive grounds, a level path runs round the house and garden. There are thirty personal rooms, including two double rooms. These rooms are located on the ground and first floor. All rooms have their own washing facilities and most have en-suite toilets. A shaft lift provides access to the upper level and a mezzanine level is accessed by a small flight of stairs that is fitted with a stair lift. The home has specailly adapted bathrooms and toilets on each floor. There is plenty of communal space with two lounges, a library, a dining room and a hairdressing room on the ground floor. The fees that were given at the time of this visit range from £525 to £650 but may vary dependent on the assessed needs of the individual. Additional charges are made for hairdressing, chiropody, newspapers, toiletries and taxis. Please contact the registered manager for futher information about the home and to confirm current charges. 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: This visit formed part of the annual inspection process of the Care Quality Commission under the provisions of the Care Standards Act. The inspection process includes a review of the information we have been given about the home prior to this visit, for example, the homes Annual Quality Assurance Assessment (AQAA) and notifications that are required by the Commission; the results of surveys we have sent to the people that use this service; and information other people, such as health and social care professionals, have given us; as well as this visit itself. During this visit we spent time talking to ten of the people that use this service some in the privacy of their rooms and others in the communal areas of the home; we spoke to some of the staff, three in private and others during the course of the day; we spoke at length with the registered manager; examined important documentation such as care plans, staff files and records of medicines ordered and administered; we made a tour of the home; and made direct and indirect observation throughout the time spent in Care Homes for Older People Page 6 of 27 the home. The people who use this service were very positive about all aspects of the care and support they receive. In particular they praised the meals in the home with comments such as, The meals are very good, All meals are of a very good quality, and, Meals are well-cooked and varied. We asked some of the people who use this service how they would like us to refer to them in this report. They told us they would like us to refer to them as Residents. Therefore we have used this term throughout this report. The residents, their supporters, the staff, deputy manager and registered manager are all thanked for the welcome they gave and their help during this visit. The home meets the standards for best care practice in all outcome areas and is assessed as providing an excellent service. The quality rating for this home is 3 stars. 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. The home gives prospective residents and their supporters good information about the home so that they can make an informed decision about moving in. Thorough pre-admission assessments are made to ensure that only those people whose needs can be met and who are suited to the home, are offered a place there. Evidence: We looked at standards 1, 3 and 6 in this outcome area. In order to assess how well the home meets these outcomes we looked at care plans and other important documentation, spoke with residents; we looked at the information we received in the form of surveys and the homes annual quality assurance assessment (AQAA); and made direct and indirect observations throughout the time we spent in the home. The home has a clear statement of purpose and service user guide. These documents give good information about the facilities and services the home provides Care Homes for Older People Page 10 of 27 Evidence: There is plenty of information about the home in the form of leaflets and notices about activities, menus and local services. Staff were observed to be very helpful in giving information to residents about what is going on in the home and a key worker system ensures that each resident has a particular member of staff who is responsible for ensuring good communication with them. The care plans of the some of the most recently admitted residents were examined. We found good evidence to show that thorough pre-admission assessments are made. Full assessments both from local authorities and the home are in place. The registered manager confirmed she visits every prospective resident before offering a place in the home. Prospective residents and their families and supporters are invited to visit and spend time in the home and stay for a meal prior to making a decision to move in. The home offers a trial period for new residents to ensure they are happy and settled. The home does not offer intermediate care. Intermediate care is a type of service offered to people who require quite intensive assessment and rehabilitation. 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. The home works hard to promote the health, independence and well-being of the residents in a way that respects their privacy and dignity. Evidence: We looked at Standards 7, 8, 9 and 10 in this outcome area. To assess how well the home meets the standards for best practice in health and personal care we spoke to ten residents and two staff in private; we sent surveys to a sample of residents, staff and visiting health and social care professionals; we examined four care plans in detail; we considered the information given to us by the home in their Annual Quality Assurance Assessment (AQAA); we looked at the way medicines are managed; and we made direct and indirect observations throughout the time we spent in the home. Four care plans were examined. All were up-to-date and in good order. They contained comprehensive information about each residents, including their likes and dislikes, cultural and religious needs, personal care needs and interests. The care plans are reviewed regularly and residents are encouraged to participate in this process as much as they are able. Care Homes for Older People Page 12 of 27 Evidence: Thorough and regular nutritional assessments are carried out and there is an excellent understanding amongst staff about the importance of good nutrition. In addition the home has moving and handling, continence and pressure area risk assessments in place. Good relationships are maintained with the Community Nursing team and their advice is sought on a number of health issues including the promotion of continence and the prevention of pressure sores. The home runs a keyworker system. This means that each resident has a named member of staff who takes prime responsibility for their care, ensuring that care reviews take place, concerns are communicated well and that the views and needs of the resident are put to the fore. The home has good working relationships with local General Practitioners (GPs) and district nurses and a chiropodist visit the home regularly. Other health and social care professionals such as physiotherapists and care managers visit as needed. Records show that hospital appointments are made and residents supported to attend appointments. The advice give by health and social care professionals is recorded and followed. We spoke to ten residents in the course of this visit. all said that they are well cared for. One said, They couldnt look after us better. They cater for our every need here. Another said, Im very happy here, the staff are marvelous - its a real home from home. On the day of this visit all the residents were in good health and spirits and said that they are able to spend their time as they wish. Throughout the time we spent in the home we observed that staff were respectful and kindly toward the residents, ensuring that their dignity was upheld at all times. The home has robust policies and procedures for the management and administration of medicines in the home. This includes policies for the use of homely remedies and self medication. Currently, two residents choose to self medicate and manage this well. Medicines are stored safely and securely and all staff who administer medicines have received competency based training and have had their competencies assessed by either the registered manager or by senior care staff. Care Homes for Older People Page 13 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. The home values equality and diversity and provides a varied and interesting programme of activities that promotes the independence of the people who use this service. Evidence: We looked at Standards 12, 13, 14 and 15 in this outcome area. To assess how well the home meets the daily activity needs of the people who use this service we looked at activity records, menus and care plans; we spoke to residents and staff; we made general observations; and reviewed the information given to us in the Annual Quality Assurance Assessment (AQAA) that the home sent us and the surveys that residents and staff returned. There is a varied programme of activities that include gardening, flower arranging, quizzes, crosswords, bingo and visiting entertainers. Activities take individual interests, choice and gender into account. The home employs a carer who has responsibility and designated time to co-ordinate activities in the home but staff are expected to support activities and take responsibility for activities at times when he is not in the home. Care Homes for Older People Page 14 of 27 Evidence: This visit was made just before Easter and preparations for this festival were in evidence in the home. There were decorations that the residents had created, Easter eggs ready for every resident and plenty of spring flowers around the home. Residents said that they have plenty to do and many said they enjoy taking part in the various activities. Some said that they really enjoy the music and singing. One resident pointed out the spring flowers growing in pots on the patio outside and said, We planted those pots up last Autumn, theyve been lovely, especially the crocuses. Respondents to our survey praised the activities. One said, I enjoy most of the activities, particularly the music activities and motivation. Another said, The activities co-ordinator is very good at jollying us all along. A few residents said that they prefer not to take part in organised activities and like to spend time in their rooms. One said, I like reading and sometimes get through a book in a day. The staff come by to see how I am but Im happy with my books and DVDs. There are regular in-house religious services and arrangements can be made to transport people to church if they wish. There are regular residents meetings and a suggestion box. Recently there has been an activities survey. As a result of consulting residents about their views, an addition has been made to the menu and different activities tried. The home keeps notes of the meetings and circulates these to the residents and their families. Residents are actively encouraged to maintain their independence. Many are able to manage their own finances, some self medicate and all have been able to personalise their rooms so that there is a pleasant, individual and homely feel to each room. There is plenty of communal space and residents were seen to be very mobile around the home. The home has a large, safe and well maintained garden. The residents said they really enjoy the garden when the weather permits. Visitors are welcomed to the home at any reasonable time. Residents said that their friends and relatives are always made welcome and that the home communicates well with their families. Since the last inspection the home has worked hard to improve food services. There is now a choice of three main meals each day and an evening snack menu has been introduced. On the day of this visit there was a choice between a meat, fish and vegetarian meal. The meals looked appetising and portions were given to individual preferences. Residents told us that they are given a menu to chose from each evening for the following day. The main meal is taken at lunchtime and most people see this as a pleasant social occasion. Care Homes for Older People Page 15 of 27 Evidence: The residents said that they enjoy their meals and that the food is very good. Some of the comments made in response to our surveys were:- Meals are well cooked and varied. the chef is an excellent pastry cook; The meals are very good and there are lots of drinks when you want them; and Food is excellent. As mentioned in the previous outcome area, good nutritional assessment and monitoring is in place and the appropriate action is taken if there are significant changes in weight. The home caters for special diets and food preferences. The dining room is light and airy and well furnished. The tables were carefully laid and there were fresh flowers on each that some of the residents had arranged the day before. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes robust policies and procedures for managing concerns, complaints and safeguarding help keep the views of the people who use this service to the fore and contribute to keeping them safe from harm. Evidence: In this outcome area we looked at Standards 16, 17 and 18. In order to make a judgement about how well the home deals with concerns, complaints and safeguarding we looked at records of any complaints that had been made; we looked at what the home had told us about the way it manages complaints and safeguarding in the Annual Quality Assurance Assessment (AQAA); we looked at the results of the surveys we sent out; and we spoke to the registered manger, staff and residents. The Grove has robust policies and procedures for managing concerns, complaints and safeguarding. The Complaints Procedure is clearly explained in the Service User Guide and a copy is posted on the Residents Notice Board. The complaints procedure is simple to understand and accessible to all. It includes information on how to refer the complaint to the Care Quality Commission (CQC) should the complainant not be satisfied with the way the home has handled the complaint. CQC has not received any complaints or expressions of concern about the home since the last inspection. Two formal complaints have been made to the home since the last inspection which was three years ago. Those complaints were dealt to Care Homes for Older People Page 17 of 27 Evidence: the satisfaction of the complainants and with in the prescribed twenty-eight day timescale. A record is kept of complaints and investigations. examination of this documentation showed that the home had made thorough investigations, responded appropriately and made changes to care practice where indicated. All residents are given the chance to vote and access to advocacy services is always available. The home does not hold residents monies. Residents finances are dealt with by the individual resident, his or her legal representative, their family, or friends. There is an accounting system for personal expenditure that the home may fund initially. Statements are prepared regularly for this so the home can obtain reimbursement. There is a safe should residents wish the home to look after valuable items for them. We were told that this facility is not used much as families usually look after valuable items for their relatives. All staff employed at The Grove have a Criminal Records Bureau (CRB) and POVA check prior to employment. These documents are kept by the manager in a secure facility and were available for inspection on the day of this visit. Staff receive training in the protection of vulnerable people and the prevention of abuse as part of their induction and further training programmes. The staff we spoke to were very clear about their responsibility to report any concerns about suspicion of any form of abuse using the homes whistle-blowing procedure. The confirmed that they have had training in this area and said that they would feel comfortable talking to the manager or deputy manager should they have concerns. The residents we spoke to said that they know they can make a formal complaint if they wish but had not had to do so. They said that any day-to-day concerns are dealt with immediately and, in general, they said they had no complaints at all. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, safe and well maintained and provides the residents with a pleasant and homely place in which to live. Evidence: We looked at Standards 19, 21, 23 &26 in this outcome area. To assess how well the home meets these standards we made a tour of the home, asked residents about how they like their environment and looked at the information the home gave us in their Annual Quality Assurance Assessment (AQAA). The home is spacious and well maintained. There is plenty of communal space with a television lounge, a quiet lounge, a small sitting room and a dining room. All areas of the home are accessible and safe. There is a shaft lift between the first and second floors and a chair lift a mezzanine floor and the first floor. The AQAA confirmed that both lifts are properly serviced and maintained. Grab handles are fitted in all corridors, bathrooms and toilets. All rooms have call buzzers and staff carry bleeps at all times. The home has a clear environmental improvement plan and rooms are re-decorated as and when possible. Residents have been able to bring items from home to personalise their own rooms and can choose colour schemes when rooms are redecorated. We saw that two rooms have recently been enlarged and refurbished to a high standard and a third is currently in the process of a complete overhaul, including widening the Care Homes for Older People Page 19 of 27 Evidence: door to the en suite toilet to improve access for the resident. Every resident has a lockable facility in their room. The home has some long corridors that get heavy use. the carpet in some areas of these corridors are now beginning to look a little tired and tape has been used to make them safe in one area. The home should consider replacing carpet in these areas. There is a good sized laundry room and the home employs a laundress as well as a number of other hotel services staff such as cleaners, a maintenance person and cooks. Robust infection control policies and procedures are in place and staff told us that the registered manager is very strict about ensuring these are followed at all times. Hand washing facilities are available in all toilets and bathrooms and both sluices. Alcohol gel is supplied throughout the home and by the sinks as well. Outside the home has parking spaces for approximately seven cars to the front and side of the building and a large, safe, well stocked and well maintained garden to the other side and rear. Residents said that they enjoy the environment of the home and especially like the views of the garden and spending time in the garden when the weather permits. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels, staff training, staff recruitment procedures and staff morale are all good so that the people who use this service are cared for by a well qualified, carefully vetted and cheerful staff team. Evidence: We looked at Standards 27, 28, 29 & 30 in this outcome area. In order to assess how well the staff meet the needs of the residents and how carefully the staff are vetted, we looked at staff rosters and a sample of staff files; considered the information in the Annual Quality Assurance Assessment (AQAA) and staff and residents surveys; and spoke to residents and staff in private. There are good staffing levels and staff turnover is low. Staff rotas are prepared well in advance and these are kept for monitoring purposes. The staff skill and experience mix is good. There are four care staff on duty in the morning shift and three in the afternoons/evenings and two waking staff and one sleeping staff at night. In addition there is an activities co-ordinator The home employs a team of ancillary staff with a cook, assistant cook, kitchen assistants, domestics, laundress and maintenance person. There a good level of staff training and development. At present eighty-two percent of Care Homes for Older People Page 21 of 27 Evidence: staff hold the National Vocational Qualification (NVQ) in care at level two or above and six members of staff have the NVQ at level three. The residents were very positive about the staff. They said that they rarely have to wait for their buzzers to be answered. Some comments made by respondents to our residents surveys were:- The night staff are all very nice and helpful; Carers are polite, well mannered and kind; The chef is an excellent pastry cook; All staff are friendly, helpful and very kind. There are robust recruitment policies and procedures in place to ensure that all staff are carefully vetted. examination of a sample of staff files showed that two references are obtained prior to employment as well as an enhanced Criminal Records Bureau (CRB)check and POVA check. are set out in the staff contract. in addition there are well maintained interview records and records of past employment history on file. Staff undertake mandatory training that includes fire training, moving and handling, first aid, food hygiene, safeguarding and health and safety. Other training pertinent to the care of the elderly, such as dementia care and diabetes, is made available when possible. The staff we spoke to said that they get plenty of training opportunities and support to put their learning into practice in the home. They were very appreciative that most of the training takes place in the home itself and therefore they do not have to spend extra time in travel. They said that the quality of training is good. The staff who responded to our surveys all said that they receive plenty of training and that the home allows them paid time to do this. There is a comprehensive induction programme which all staff work through in their first six weeks of employment. This is in line with the Skills for Care induction standards. The home has an annual diary of training with a local training company so staff have plenty of notice as to when training will take place. 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. The home is very well manged and run in the best interests of the people who use this service. Evidence: We looked at Standards 31, 32, 33, 35 and 38 in this outcome area. In order to make a judgement about how well the home is managed we looked at the information the home gave us in their Annual Quality Assurance Assessment; we considered the feedback given to us in the surveys we sent to a sample of the residents and staff; we spoke at length with the registered manager and spent some time talking to the deputy manager and staff; and we made a tour of the home to ensure there were no health and safety hazards. The registered manager has been in post for over three years. She is well qualified and experienced. She is qualified nurse (Registered General Nurse -RGN) who has maintained her registration with the Nursing and Midwifery council (NMC) and continuing professional development. She holds the diploma in Professional Nursing Care Homes for Older People Page 23 of 27 Evidence: Studies, the Registered Manager Award (RMA) and two teaching certificates (ENB998 and City & Guilds 7407. She is supported by a deputy and works closely with the registered provider to ensure the smooth running of the home. Staff feedback about the management of the home was very positive. Staff praised the support they receive from the manager and the deputy and said they feel comfortable talking to either of them about any issues they may have. Discussion with the registered manager showed her to be knowledgeable about, and committed to, best care practice. She is committed to staff training and development and this is reflected in the enthusiasm of the staff for learning. The registered provider visits the home frequently and makes monthly quality assurance reports in accordance with Regulation 26. The organisational structure in the home gives clear lines of responsibility at all levels. This means that staff and managers are clear about their roles and responsibilities and reporting mechanisms. Residents are actively involved in giving feedback about the way home is run and there are audit tools to look at systems and processes throughout the home. There are regular resident and relatives meetings which are held in an open and friendly style. There is an annual quality assurance questionnaire as well as internal monthly quality assurance questionnaires. Feedback from these is recorded. The Grove has a thorough staff induction process and operates an appraisal and supervision system for all staff. The AQAA confirmed that records are stored safely and securely and that the required certificates are current and in place for gas and electrical supply and appliances, water temperatures and maintenance of the building to ensure the health and safety of residents and staff. The registered provider and the registered manager take responsibility for ensuring that all staff comply with all relevant health and safety legislation. No health and safety hazards were noted during the tour of the building 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 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). 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