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Care Home: The Homestead

  • 6 Elwyn Road Exmouth Devon EX8 2EL
  • Tel: 01395263778
  • Fax: 01395273371
  • Planned feature Advertise here!

  • Latitude: 50.619998931885
    Longitude: -3.3949999809265
  • Manager: Mrs Linda Lambeth
  • Price p/w: ~
  • UK
  • Total Capacity: 24
  • Type: Care home only
  • Provider: Homestead Homes Ltd
  • Ownership: Private
  • Care Home ID: 15996
Residents Needs:
Old age, not falling within any other category, Physical disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 31st December 2009. CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

For extracts, read the latest CQC inspection for The Homestead.

What the care home does well There are good admission procedures in place. They make sure people have as much information about the home as they need and they give plenty of opportunities for people to visit and get to know the home before they decide to move in permanently. Assessment procedures are thorough and ensure they can be certain they will be able to meet the person`s needs before they confirm the person can move in. There are detailed care plans in place for each person that give the staff very good information about the care and support needed. There is a well trained and experienced staff team and people we talked to praised the staff team for the excellent care they provide. We saw staff supporting people in a discrete and respectful manner and we saw evidence of the way staff understood each person`s health and personal care needs and how they gave attention to detail, no matter how small, to make people feel comfortable and safe. The home provides an excellent variety of activities to suit all interests. There is a day centre that is open to people outside of the home. People have been consulted to find out what things they would like to do. There is a timetable of the activities offered for the forthcoming month and this showed that there is at least one activity offered each day. We talked to two relatives who were visiting the home that day. We heard lots of praise for the home and were satisfied that friends and family are always made welcome and involved in all aspects of the home. We saw visitors having lunch with their relative. People are offered a balanced and nutritious range of well cooked meals with plenty of choice to suit all preferences. We heard lots of praise for the high standard of the meals provided. We saw evidence to show that all individual likes, dislikes and dietary needs have been catered for. People told us they were confident that any complaints or concerns they might have would be listened to and acted upon promptly. The complaints procedures was prominently displayed in the home and there were recording systems in place if they should receive any complaints, although none have been received in the last year. They have good training programmes in place to make sure staff are fully aware of the actions they must take if they have any concerns that a person may be at risk of harm or abuse. The home has been attractively decorated and furnished throughout. All areas have been well maintained and there is a regular programme of redecoration and refurbishment for all rooms. The home was clean, warm and safe. The staff demonstrated a great pride in the home and there was attention to detail in all areas to make the home appear welcoming and stylish. The staff team have been well trained and a high proportion of the staff team hold a relevant qualification. There are good recruitment procedures in place to make sure new staff are completely suitable for the job before they begin work.The home is well managed and safe. There are excellent procedures in place to make sure people are fully involved and consulted to make sure the home is continually providing a good service. What has improved since the last inspection? No requirements or recommendations were made at the last inspection. The home was able to demonstrate that they have excellent systems in place to make sure they are constantly improving the standard of the services. They told us about many improvements they have made to the home and to the services in the last year. Many of these have been made as a result of talking to people living in the home and responding to their suggestions. What the care home could do better: While we were satisfied that medicines have been safely stored and administered we suggested some minor improvements that would make it even safer. These included better information to be given to care staff about each medicine administered, and better accounting systems for those medicines not supplied in the monitored dosage packs so that they know what stocks are carried forward each month. The staff application forms should be amended to ensure a full employment history is obtained before considering if the applicant is suitable for the post Key inspection report Care homes for older people Name: Address: The Homestead 6 Elwyn Road Exmouth Devon EX8 2EL     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: Vivien Stephens     Date: 3 1 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: The Homestead 6 Elwyn Road Exmouth Devon EX8 2EL 01395263778 01395273371 info@homesteadhomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Homestead Homes Ltd Name of registered manager (if applicable) Mrs Linda Lambeth Type of registration: Number of places registered: care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home The Homestead is a detached Edwardian house set in large well kept gardens in a residential area of Exmouth close to shops and all local facilities. Accommodation is provided in 18 single bedrooms, 15 of which have en suite facilities, and 3 double bedrooms with en suite facilities. There are 2 lounges, and a dining room. One of the lounges provides day care facilities for residents and people who live elsewhere and visit the home for the day. There is also a small quiet sitting area plus a large entrance conservatory with a couple of chairs where some service users enjoy sitting. Care Homes for Older People Page 4 of 28 Over 65 24 24 0 0 Brief description of the care home The home provides personal care for up to 24 older people who may also have a physical disability. There are waking staff on duty at night. The home places a high priority in providing a wide range of activities and outings to suit all interests. The fees at the time of this inspection were from £420 to £600 per week and did not include hairdressing, chiropody, papers and magazines and accompanied hospital visits. A copy of this inspection report is made available to visitors, staff and residents in the home. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Before this inspection took place we asked the home to complete an Annual Quality Assurance Assessment (AQAA). They completed the form when we asked for it and it gave us excellent information about all aspects of the management of the home. We also sent some survey forms and asked them to distribute these to a random selection of people living in the home. We received 9 completed forms. Their responses have helped us to form the judgements we have reached in this report. Our visit lasted approximately seven hours. During the day we talked to the manager, Lyn Lambeth, and to one of the directors. We looked at four care plan files and talked to these people to find out if the care needs described in the care plan files were accurate, and to find out if they were satisfied that they received the care and support they wanted. We also talked to two relatives who were visiting the home that day, and four members of staff. Care Homes for Older People Page 6 of 28 We carried out a tour of the home and the grounds. We looked at the way medicines have been stored and administered in the home. We talked to the cook and looked at the way the meals have been planned in order to meet all dietary needs and preferences. We also looked at many of the records the home is required to keep, including fire safety records. Care Homes for Older People Page 7 of 28 What the care home does well: There are good admission procedures in place. They make sure people have as much information about the home as they need and they give plenty of opportunities for people to visit and get to know the home before they decide to move in permanently. Assessment procedures are thorough and ensure they can be certain they will be able to meet the persons needs before they confirm the person can move in. There are detailed care plans in place for each person that give the staff very good information about the care and support needed. There is a well trained and experienced staff team and people we talked to praised the staff team for the excellent care they provide. We saw staff supporting people in a discrete and respectful manner and we saw evidence of the way staff understood each persons health and personal care needs and how they gave attention to detail, no matter how small, to make people feel comfortable and safe. The home provides an excellent variety of activities to suit all interests. There is a day centre that is open to people outside of the home. People have been consulted to find out what things they would like to do. There is a timetable of the activities offered for the forthcoming month and this showed that there is at least one activity offered each day. We talked to two relatives who were visiting the home that day. We heard lots of praise for the home and were satisfied that friends and family are always made welcome and involved in all aspects of the home. We saw visitors having lunch with their relative. People are offered a balanced and nutritious range of well cooked meals with plenty of choice to suit all preferences. We heard lots of praise for the high standard of the meals provided. We saw evidence to show that all individual likes, dislikes and dietary needs have been catered for. People told us they were confident that any complaints or concerns they might have would be listened to and acted upon promptly. The complaints procedures was prominently displayed in the home and there were recording systems in place if they should receive any complaints, although none have been received in the last year. They have good training programmes in place to make sure staff are fully aware of the actions they must take if they have any concerns that a person may be at risk of harm or abuse. The home has been attractively decorated and furnished throughout. All areas have been well maintained and there is a regular programme of redecoration and refurbishment for all rooms. The home was clean, warm and safe. The staff demonstrated a great pride in the home and there was attention to detail in all areas to make the home appear welcoming and stylish. The staff team have been well trained and a high proportion of the staff team hold a relevant qualification. There are good recruitment procedures in place to make sure new staff are completely suitable for the job before they begin work. Care Homes for Older People Page 8 of 28 The home is well managed and safe. There are excellent procedures in place to make sure people are fully involved and consulted to make sure the home is continually providing a good service. 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 9 of 28 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 28 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. People can feel confident that they will be given as much information and opportunity to get to know the home as they will need before deciding to move in permanently. The home takes care to get to know each person and understand their care needs before agreeing to let them moeve in. Evidence: There is good written information about the home that is given to anyone who may be thinking about moving in. The Statement of Purpose has recently been updated and covers all required topics in straightforward and easy to read language. They also have an internet web site giving useful information and pictures about the home. We looked at the way the home has assessed peoples needs before they moved in. We found that the home had excellent procedures in place. They have gathered as much information as possible about each person by visiting them and completing an assessment. People have been encouraged to visit the home for the day, or to have a Care Homes for Older People Page 11 of 28 Evidence: short stay to help them get to know the home and decide if it is the right place for them. During these visits the home has gathered further information for the assessment process. If an assessment has been carried out by a hospital or a social worker this information has been obtained and has helped the home to decide if they will be able to provide the right care and accommodation to meet the persons needs. People have been admitted on the understanding that the first few weeks are a trial period. This means they can take their time to make up their minds if the home is right for them. A contract has been given to each person when they have moved in setting out the terms and conditions of their accommodation. The people we talked to, including two relatives who were visiting that day, said they were entirely happy with the information they had received and the welcome they had received from the home before they had decided The Homestead was the right place for them. Care Homes for Older People Page 12 of 28 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. People can be confident they will receive all the support they need and want with all their personal and health care needs. Medicines have been safely stored and administered by well trained and competent staff. Evidence: We looked at the care plan files for four people living in the home. We also met these four people and talked to them about the care they received. We were able to see that the care needs described in the care plans accurately reflected the support each person wanted from the home with each aspect of their health and personal care needs. The care plan files were neat and tidy and each section was clearly labelled. This meant it was very easy to find relevant information quickly. The files provided essential personal information about each person for example date of birth, next of kin, and other people involved in their care including their GP and health Care Homes for Older People Page 13 of 28 Evidence: professionals. There was a snapshot overview of their daily care needs giving brief information to the care staff about how the person wanted to be assisted. The main care plan section contained more detailed information about each care need, including the aims, and explained clearly how the tasks should be carried out. The files contained risk assessments on all relevant potential risks, including skin care and the risk of pressure sores. We saw excellent examples of good care by care staff where one person had been assessed as at potential risk of pressure sores. The person had a special cushion to sit on and a care worker collected the cushion from the persons room and placed it on their dining chair before they sat down at the lunch table. This showed that the care staff had a very clear understanding of the persons health care needs. We saw evidence from the home to show that they have consulted all health professionals who have visited regularly in the homes quality assurance procedures. One district nurse who has visited the home commented I have visited the home 4 times in the last few days and have been VERY impressed with the high standard of care this lady received. The staff were kind, patient, empathetic and very professional in their work. We looked at the way the home has stored and administered medicines. Most tablets have been supplied in monthly monitored dosage packs supplied by a local pharmacy. This system was easy to use and reduced the risk of possible errors or omissions. There were safe storage facilities for all medicines, including controlled drugs and medicines that needed to be kept in a refrigerator. We looked at the records of medicines that have been administered and we found they had been correctly completed and there were no unexplained gaps. All staff who have been given responsibility for administering medicines have received training on this task and their competency has been carefully checked before they have been allowed to carry out this task. While most medicines have been supplied in monthly blister packs some medicines and creams were not supplied in this system and the home had small stocks carried forward at the end of each month. We recommended that the home keeps a balance of the amounts held at the end of each month and carried forward to the next in order to provide a robust accounting system for all medicines. At the time of this inspection all creams were held in peoples bedrooms and staff Care Homes for Older People Page 14 of 28 Evidence: completed a record of the administration that was kept in the room with the creams. We saw that these had been well recorded. Those people who had decided they wanted to hold and administer their own medicines had secure lockable facilities in their rooms. The home were considering providing similar cupboards in every bedroom. The medicine administration charts provided a good level of information about medicines where there were special administration needs. We suggested that the home also provides further information about each medicine including what it is for, any possible side effects, and other potential risks. Where medicines have been supplied on an as required basis, and where people may have occasional pain, there should be information on when the medicines should be administered. The home told us in their AQAA that they plan to implement this. Care Homes for Older People Page 15 of 28 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 provides an excellent variety of activities to suit all interests. Friends and family are always made welcome and involved in all aspects of the home. People are offered a balanced and nutritious range of well cooked meals to suit all preferences and dietary needs. Evidence: We looked at the range of activities provided by the home. We found that the home has placed a very high priority on providing a wide range of interesting activities to suit every person. They had a day centre that operated 4 days per week providing a very wide range of activities for both people living in the community and people living in the home. Activities provided in the day centre have included cooking, trips out, board games, and arts and crafts. The room has a large stock of equipment including games and arts and crafts materials. Regular activities have been provided throughout the home and have not been confined solely to the day centre. People have been consulted in a range of ways to find out what they would like to do. Consultation has included through monthly Care Homes for Older People Page 16 of 28 Evidence: residents discussion groups. The range of activities have included - card games, classical musical afternoons hosted by a resident, afternoon films, seasonal parties, crossword sessions, coffee mornings, trips in the local area, quizzes. We were given a timetable of the activities planned for the coming month showing a wide variety with at least one activity offered every day. These included visits from people outside the home including professional entertainers, beauty and therapy professionals, and visits from representatives of local churches. We found good evidence to show that the home has respected the wishes of those people who did not wish to join in with regular organised group activities. Care staff have spent extra time with people who have chosen to remain in their rooms either sitting and chatting, or supporting them with their individual interests. We talked to two relatives who were visiting the home and they were full of praise for the owners and staff and the way they were made welcome whenever they visited. One person had invited their relatives to join them with the lunchtime meal. Seasonal parties have been held in the home for residents and their families and friends. We were also given a copy of the presentation given to relatives and friends at a recent Residents Family and Friends meeting. This demonstrated that the home actively involved and informed relatives and friends in all aspects of daily life in the home. One relative told us about a recent party in the home and told us The food was out of this world! One person who lived in the home completed a survey form before this inspection. We asked them What does the home do well? They told us, CARE. When friends and family come there is always a welcome. They say the atmosphere is so good - the best. We were given a copy of the current menus. People were offered at least two choices for each meal. We were satisfied that people could ask for alternatives if they did not like the main meals offered. The cook showed us a large notice in the kitchen showing each persons special dietary needs and all likes and dislikes. The dining room was bright and comfortable and had been tastefully furnished and decorated. The room was decorated for Christmas with attractive seasonal table cloths and wall and table decorations that made the room appear cheerful and welcoming. We saw evidence of staff treating people respectfully and offering discrete support where necessary with their meals. Every effort was made to make peoples mealtimes and enjoyable social occasion, including the offer of a glass of wine or sherry with Care Homes for Older People Page 17 of 28 Evidence: their meal. The kitchen was well equipped and modern. It had been inspected by the Environmental Health Officer in the last 18 months and everything was found to be satisfactory. There were good supplies of food including fresh fruit and vegetables all neatly stored. People told us they always enjoyed the meals and they praised the standard of the cooking. Care Homes for Older People Page 18 of 28 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. People can be confident that any complaints or concerns will be listened to and acted upon promptly. The home has taken all possible steps to minimise the risk of abuse through good training programmes and effective policies and procedures. Evidence: People we talked to, and those who completed a survey before this inspection, told us they knew how to make a complaint. We saw copies of the complaints procedure in large print displayed on notice boards around the home and people have also been given the procedure in the information given to them before they moved in. No complaints or concerns about the home have been received by the Commission since the last inspection. The home told us they had not received any complaints in the last year. The people we talked to, including staff members, said they were entirely confident that any concerns or complaints raised with the owners or management team would be listened to and taken seriously, and addressed promptly. All staff have received training on the protection of vulnerable people. They have also received training on the the Deprivation of Liberty and the Mental Capacity Act. The home have updated their whistle blowing procedures and staff have easy access to all policies and procedures in The Homestead Handbook. Care Homes for Older People Page 19 of 28 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 staff team have demonstrated a pride in their work by making sure that people live in a warm, clean, comfortable and safe home. Evidence: We looked around the house and gardens and found all areas had been well maintained and were bright, clean and safe. In the last year some changes have been made to the garden following consultation with the people living in the home. New paths have been laid to provide better access around the home. A new patio area has been created and new garden furniture provided. The gardens have been very well maintained and provide a plenty of interest with flower beds, mature trees and shrubs and well tended lawns. We looked at a random selection of bedrooms and found they were attractively decorated, bright and comfortable. The furniture and furnishings were of a good quality. People have been encouraged to bring items of furniture and personal effects to make their rooms feel homely. All of the lounges, dining room and corridors were attractively decorated and furnished. There were attractive Christmas decorations throughout the home and the staff team demonstrated a great pride in the appearance of the home. The cleaning Care Homes for Older People Page 20 of 28 Evidence: staff had good routines in place and all areas were bright, fresh and exceptionally clean. The home told us in their AQAA that they have made many improvements to the home in the last year. Ten bedrooms have been redecorated and many had also been re-carpeted and new curtains provided. A new chandelier has been purchased for the entrance hallway, a new sideboard has been purchased for the dining room (these have been following discussions with people living in the home). Many other improvements have also been made around the home. Many of the bedrooms had en suite facilities. The shared bathrooms and toilets were modern, bright and attractive and there was a good level of equipment to ensure people with poor mobility could use the bathrooms safely. The home told us in their AQAA that all equipment has been serviced and maintained regularly. Good infection control measures have been put in place including measures to prevent Legionella. The laundry room was in good working order, clean, neat and tidy. Care Homes for Older People Page 21 of 28 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. People living at The Homestead receive the care and support they need from a well trained and qualified staff team. Evidence: On the day of this inspection there were 20 people living in the home. 2 new people were due to arrive in the next few days. There was a manager and one of the directors present plus 1 senior care assistant, 2 care assistants, 3 cleaning staff, 1 cook, and a kitchen/laundry assistant. (We were told that on Wednesdays there is usually an additional member of cleaning staff making the total of 4). There was also a gardener/maintenance person. We were also told that there would usually be a Day Centre Co-ordinator, and Office Co-ordinator and an additional maintenance None of the people living in the home were poorly or needed a high level of assistance. The staff team were relaxed and cheerful and were able to complete all required tasks efficiently. Therefore we were satisfied that the staffing levels were satisfactory and met the needs of the people living there. We looked at the recruitment files of 4 staff employed since the last inspection. We found the home had followed good procedures by obtaining at least two satisfactory references and a confirmation that the person had not been barred from working with vulnerable adults. They had obtained a Criminal Records Bureau check for each person (although these had not been received until after the staff member had begun work). Care Homes for Older People Page 22 of 28 Evidence: We saw evidence to show that they had usually asked about previous employment experience during the interviews. Some applicants had voluntarily supplied a full employment history in a document known as a CV. However, the homes application form did not specifically ask people to supply information about their previous history. We discussed this with the manager and director and they agreed to amend their application form and ensure that all future applicants provide this information. We looked at the way new staff have been inducted as the start of their employment. We saw documentary evidence to show that all new staff have received thorough induction training to meet nationally recognised standards. We were also given a copy of the homes staff training matrix showing the dates each member of staff have received training on health and safety topics and other relevant health and personal care topics including diabetes, nutrition, continence, and dementia. Over 85 of the staff team held a relevant nationally recognised qualification known as NVQ to at least level 2 or above. Of these, 10 staff held an NVQ at level 3. All senior care staff had an NVQ to either level 3 or level 4. This demonstrated a very high commitment by the home to ensure they have a well trained and well qualified staff team. The staff we spoke to told us they really enjoyed working at The Homestead. They were clearly very proud of the home and the high standards achieved throughout. They said there was excellent teamwork and very good support systems including regular supervision and staff meetings. Care Homes for Older People Page 23 of 28 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. People live in a well managed and safe home. There are excellent procedures in place to make sure people are fully involved and consulted and to make sure the home is continually providing a good service. Evidence: The manager of the home, Lyn Lambeth, has satisfactorily completed an application to register with the Commission in the last six months. This means we are satisfied that she is suitably experienced and qualified and fit to manage the home. She holds a nationally recognised qualification known as NVQ level 4 and she was in the process of completing the management qualification (this is required as a condition of her registration). The owners and directors of the home are in full day to day contact and are closely involved in the management of the home and ensuring the standards are constantly maintained. Care Homes for Older People Page 24 of 28 Evidence: All of the people we talked to, including people living in the home, relatives and staff, praised the owners and management team for the smooth running and high standards maintained. The home has an excellent range of methods in place to make sure the quality of care and facilities are constantly maintained. The AQAA was completed when we asked for it and provided an exceptionally high level of information about all aspects of the home. They were able to demonstrate how they have improved the home over the last year, and how they have recognised where further improvements are necessary. They have consulted with everyone who lives in the home, their relatives and visitors, the staff team, and health and social care professionals. They have given people feedback about the outcome of their quality assurance process. We looked at the way the home has helped those people to look after their cash if they did not want to hold the cash in their rooms. There were good records in place with accurate balances held and receipts to show any purchases made. There were good procedures in place to make sure the home was safe. We looked at the fire log book and we were satisfied the home had carried out all required maintenance and safety checks. They had recently drawn up a fire evacuation plan of the home with diagrams placed in every bedroom. Staff have received regular training and updates on all required health and safety topics. The home told us their policies and procedures on health and safety topics have been regularly reviewed and updated where necessary. Risk assessments have been carried out on all areas of the building and the equipment used. Care Homes for Older People Page 25 of 28 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 26 of 28 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 8 Better information should be given to care staff about each medicine including what it is for, any possible side effects, and other potential risks. This should include medicines prescribed on an an as required basis, and medication for pain relief. Balances should be recorded each month for medicines that are not included in the monitored dosage packs. This will ensure there is an accounting system for all medicines held in the home. The application forms should be amended to ensure a full employment history is obtained before considering if the applicant is suitable for the post. 2 29 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!

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