Care Home: The Lakes Nursing Home

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What the care home does well The service benefits from a strong and dedicated management team who appear committed to ensuring people`s needs are met in the most appropriate ways. People`s needs are clearly identified in their individual care plans and wherever possible, the person has been involved in the development and reviewing of their plans. Staff are good at monitoring people`s day to day needs, and where changes to those needs are identified, relevant action was quickly taken. The home has achieved the Gold Standard Framework (GSF) Award which recognises the high standard and quality of care given to someone nearing the end of life. Activities are available on a daily basis and are planned according to what people want to do with consideration being given to the abilities and needs of the people participating. People working in the home are recruited following a rigorous recruitment and selection procedure. The induction training is thorough and ensures staff are aware of the basic principles of delivering a high quality service. The home has Investors in People status which is a recognised award for quality. What has improved since the last inspection? The way care plans are written and developed on Derwent Suite has improved. Much more detail was being included to identify each assessed need and the person was much more at the centre of the plan and was being identified as an individual with individual needs. Activities in the home had significantly improved and more detailed records of the activities taking place were being kept. A lot of improvements have taken place in the home during past 12 - 18 months to improve the environment and to further develop the service. More rooms had en-suites in situ and people had access to newly refurbished toilets and bathrooms. The main lounge on Derwent Suite had been extended, with new UPVC windows fitted throughout and new offices had been made for the registered manager and staff in charge. Other examples of improvements are contained within the report. A new call bell system has been installed ensuring that every call a person makes for assistance is recorded, monitored and acted upon. The management structure within the home has been further developed to include the support of a Care Coordinator, Property Manager and a Human Resource Manager. Such a strong management team has enabled the service to develop to a high standard. What the care home could do better: No requirements or recommendations have been made following this key inspection. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Lakes Nursing Home Off Boyds Walk Dukinfield Tameside SK16 4TY     The quality rating for this care home is:   three star excellent 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: John Oliver     Date: 0 8 0 7 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 28 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 28 Information about the care home Name of care home: Address: The Lakes Nursing Home Off Boyds Walk Dukinfield Tameside SK16 4TY 01613302444 01613390087 michelle@lakescare.co.uk 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) : Blackcliffe Limited care home 49 Number of places (if applicable): Under 65 Over 65 0 49 0 dementia old age, not falling within any other category physical disability Additional conditions: 49 0 49 The maximum number of people who can be accommodated is: 49 The registered person may provide the following category of service only: Care home with Nursing - Code N, to people of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Dementia - Code DE, Old age not falling within any other category - Code OP, physical Disability - Code PD. Date of last inspection Brief description of the care home The Lakes Nursing Home is a large home situated in Dukinfield, with easy access to Hyde, Ashton and Stalybridge. The home is owned by a private company called Blackcliffe Limited. Accommodation is provided across two buildings, divided into two suites named after Care Homes for Older People Page 4 of 28 Brief description of the care home areas in the Lake District. Derwent Suite can accommodate service users who require both nursing and personal care, whilst Kendal Suite provides accommodation for service users who require personal care only. All rooms are single and approximately half of the rooms have en-suite facilities, whilst the others have toilet and bathing facilities nearby. A large number of communal rooms provide a variety of areas in which service users can socialise, dine and participate in activities that may take place within the home. The current weekly fees range from three hundred and fifty eight pounds and eleven pence (plus) to four hundred and eighty seven pounds and sixty six pence (plus) dependent on the package of care required. Further details regarding fees are available from the manager. Additional charges may also be made for hairdressing, chiropody and other personal requirements. 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: This inspection was undertaken as part of a key inspection, which includes an analysis of any information received by us (the Care Quality Commission) in relation to the home prior to the visit. Before visiting the home, we asked the manager to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they considered they needed to do better. This helped us to determine if the management of the home viewed the service they provide the same way we assess the service. To support the inspection process and to complete the report we may have used Care Homes for Older People Page 6 of 28 additional information supplied to us by the manager such as notification of any incidents that have taken place in the home and any concerns or complaints received. During the inspection visit time was spent talking to a number of people using the service, observing how staff work with people and talking to the manager and staff on duty. Documents and files relating to people and how the home is run were also seen and a partial tour of the building was made. The last Key Inspection of the service was carried out on the 17th July 2007 and the last Annual Service Review was on the 17th July 2008. What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 28 No requirements or recommendations have been made following this key inspection. 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 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs were assessed prior to admission so that the management of the home could decide whether they could support those needs. Evidence: All admissions to The Lakes Care Centre are pre-assessed before moving in wherever possible and prospective users of the service are invited to spend some time at the home to see if they like it. They can stay for a day and experience having a meal and socialising with people living in the home. This gives people the opportunity to ask relevant questions, look at the accommodation on offer and speak to the managers and staff. Sometimes people come directly from hospital and a visit cannot be arranged beforehand but the manager told us that every effort would be made to make sure the person was admitted into their new home with sensitivity and that they would be Care Homes for Older People Page 11 of 28 Evidence: introduced to staff and other people using the service. We examined a number of care plan files including two recent admissions and all contained a fully documented pre-admission assessment. To support the admission into the home other information was also seen to be available including Nursing Assessments and information from other health care professionals that are or have been involved in the persons care prior to moving in. It is important that all available information is gathered prior to and during the admission into the home to enable a detailed care plan to be developed. 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. Peoples health needs were known and support was available to access the relevant services. The medication administration system made sure that people had taken the medication they require to stay healthy. Evidence: Each person living in the home had an individual plan of care on their files. Although the style of plans were different on the nursing unit from those used on the residential unit, both style of plan clearly identified the needs of the person receiving a service and described how those needs should be met. Since the last key inspection in July 2007 a lot of effort had been made on the nursing unit to improve how information was recorded in the care plans and that the plans were much more person focussed. Discussion with the manager and staff confirmed the efforts that had been made to improve how care plans were written. On Kendal Suite (residential) the care plan format gave excellent details of an Care Homes for Older People Page 13 of 28 Evidence: individuals assessed needs and how these needs should be met in the most appropriate ways. All care plans were being reviewed on a monthly basis or sooner if necessary. Wherever possible, the person or their representative had signed the care plans. When a person is first admitted into the residential suite a Care Plan for New Admissions is developed using all the information provided at the pre-admission assessment and from talking to the person and their families/representatives. The care plan of one recently admitted person clearly identified that they had been admitted to the home underweight and this was clarified on the nutritional risk assessment with clear instructions to staff on what must be done to monitor the situation. Another persons care plan identified they had lost weight and for staff to provide additional supplements to the individuals diet and to closely monitor. Evidence was available to demonstrate that this had been done and the person had gradually put weight back on over a number of months. Monitoring care plans in this way and taking positive action when needed can only enhance the support provided to people using the service. The service provides excellent care to people who are nearing the end of life and holds the Gold Standards Framework (GSF) Award. The GSF promotes choice and autonomy for people (patients) and their families regarding preferred place of care and death. To further help people at such difficult times, especially relatives and families, the manager has developed a brochure for dealing with bereavement. The brochure contains simple but important information about dealing with death and has contact telephone numbers of supporting agencies available in the community. The home received the Dignity in Care Award 2008 as a regional finalist from the end of life team. It is important that people using the service and their families and friends know support will be available at such difficult times. Observation of staff interacting with people using the service confirmed that good, positive and respectful relationships had been developed. Staff discreetly supported people when assisting them with personal requests such as toileting and bathing. We aslo watched staff as they used equipment such a mobile hoists to assist people. Health and safety was maintained at all times whilst ensuring that the person felt comfortable and safe during transfers and other activities. Individual records clearly indicated that other health care professionals such as District Nurses, GPs and Optical services were routinely supporting peoples identified health care needs. Care Homes for Older People Page 14 of 28 Evidence: Medicines on Derwent Suite (nursing) are administered by nursing staff only and it was confirmed that all staff with this responsibility had received relevant training. We checked the Controlled Drugs and found records and balances of this medication to be correct and appropriately recorded. On Kendal Suite (residential) the manager and senior carers had the responsibility for administering medicines. We spoke to the senior carer on duty who had also administered medication during our visit. We were told that all staff with the responsibility for adminstering medicines had received appropropriate training from the Primary Care Trust (PCT) with the manager of the unit regularly carrying out spot checks on medication administration and records. The home used a monitored dosage system and this medication was securely stored in a lockable medication trolley. We checked a number of Medicartion Administration Records and found them to be appropriately recorded and no gaps apparent in signatures of staff. We randomly selected some medication that was not administered from the monitored dosage system and found the records and balances of this medication to be correct. We spoke to a number of people living in the home about the service they received and comments included, Staff are great - wonderful, The staff are very caring and helpful, It is very rare you have to wait for anything - I wouldnt live anywhere else and, I get my tablets when I should. During our visit we also spoke to one relative who was visiting on Kendal Suite and their comments included, This home is the best one around, the meals are very very good with lots of choice being offered. Staff are wonderful, they support all the residents very well indeed and often take the residents out...I can see my mums care plan at any time and I know they are currently monitoring her sleep pattern - in ten years I have never had one complaint about the service. We also had the opportunity to speak with a health care professional who was visiting the home and they told us Staff are very helpful and the residents are looked after very well, the atmosphere is always calm and relaxed. If it wasnt a good service I wouldnt come to the home. 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. People were supported to make choices and maintain control over their own daily routines and activities. Evidence: A dedicated activities coordinator was employed in the home. This person had a lot of experience and was well known by people using the service. There was an excellent choice of activities made available on a daily bases and these ranged from simple board games to baking sessions and visits to the local community such as shops, pubs and restaurants in the evening. Records were kept of those activities people enjoyed participating in. Consideration had also been given to the abilities and needs of people when participating in activities. We saw that larger versions of board games such a snakes and ladders had been purchased to enable those whose sight might be impaired or may have difficulty with their dexterity to participate. It is important that consideration is given to the needs of all people living in the home when arranging activity sessions to ensure peoples needs do not disclude them from participating wherever possible. Care Homes for Older People Page 16 of 28 Evidence: People using the service were very complimentary about the range of activities available and about the activities coordinator as well. All those we spoke to knew her by name and comments included, I enjoy baking - we bake then have the things we make with a cup of tea later, I enjoyed colouring - I can sit for hours doing this, I go to the pub when I want - we went to Blackpool the other week and Staff will sit and read the paper with me, keeps me up to date. One of the special activity projects carried out this year was producing a calendar. This calendar was of a standard that you would purchase in a store and a copy had been given to relatives of people living in the home. A lot of work and effort had been put into this venture. No restrictions were placed on people visiting the service and arrangements were in place for people to receive visitors at any time. During our time in the home were saw that a number of people enjoyed entertaining their visitors in the privacy of their own rooms. One visitor we spoke to told us, I am always made to feel welcome by staff, it is never any different. I can have a meal with my mum if I want and can use the small kitchen to make myself a drink at any time. Appropriate dining facilities were available on both Derwent and Kendal Suites and meal times were seen to be a time to encourage social interaction between people living in the home. With staffs encouragement, people chose what they wanted to eat from a varied menu and the qualified catering manager ensure that healthy and nutritious meals were always available. Menus were seasonal and were displayed outside the dining rooms. The days menu was also written in large print on a chalk board. Each person was asked for their meal preference and this was then recorded. If there was anything a person did not like, various alternative choices were made available. One person spoken to told us, I got up a bit late this morning but I still enjoyed my sausage, bacon and eggs - the food and choice you get is really good. Further discussion with this person demonstrated that peoples choice of lifestyle was respected as he told us, I go out most days when I feel like it, I go to the pub for a pint and then come back when Im ready. Care Homes for Older People Page 17 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. The policies, procedures and staff practices were present to protect vulnerable people from abuse and protect their wellbeing. Evidence: There was a clear and comprehensive complaints procedure in place that was made available to all people using the service, their relatives and friends and was also accessible to staff. Details within the procedure indicated timescales for responses and included information on how to contact other, relevant external agencies such as the Care Quality Commission (CQC) and local Social Services departments. From records we saw that two complaints had been made within the last 12 months and both had been satisfactorily dealt with using the complaints procedure. We spoke to a number of people living and working in the home and all were confident that any complaints they may wish to raise would be dealt with appropriately. No complaints or concerns had been raised with the Care Quality Commission within the last 12 months. The manager confirmed that all staff had completed training in the Protection of Vulnerable Adults and we saw evidence of this training on staff files. Those staff spoken to during the visit were very clear on the procedure to follow should an allegation be raised. We saw evidence of a number of safeguarding referrals that had been made to the local authority by the manager of the service. The details of these Care Homes for Older People Page 18 of 28 Evidence: referrals demonstrated that the management team had the best interests of people at the centre of service delivery. 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 premises were extremely well maintained, safe, clean and offered enough space and flexibility to meet peoples needs. Evidence: Since the last key inspection in July 2007, the provider has invested a substantial sum of money to refurbish, extend and improve facilities throughout the service. The refurbishment work to date has included, more en-suite facilities being installed, new managers and nurses offices, extended lounge facilities with velux windows installed in the roof to allow natural light in, energy saving lighting and new high specification UPVC double glazed windows throughout Derwent Suite. One major change has been the installation of a new top of the range wireless nurse call system. This system allows the management and staff team to monitor every call answered and logged via the computer system. All checks on people using the service made by staff during the night are automatically recorded for future reference. This means that people using the service and their families/relatives can have the peace of mind knowing that a call for assistance will never be missed or forgotten. A specially adapted wheelchair lift had been installed on the first floor of Kendal Suite (residential). This enables all people using wheelchairs full access to all parts of the Care Homes for Older People Page 20 of 28 Evidence: building and that peoples choice, rights and independence can be maintained wherever possible regardless of mobility status. All bedrooms viewed were furnished to a high standard and were personalised to reflect the character of the person whose room it was. Externally, the grounds have been improved with increased parking for visitors and dedicated parking spaces for people such as GPs, District Nurses and emergency services. A new bin store compound has been provided, enabling easy access for waste vehicles and this compound area also incorporates a secure gas/oxygen cylinder store away from the main buildings. In the extensive park like grounds of the home a woodland footpath has been created after consultation with appropriate therapist to ensure materials and gradients allow for maximum effective usage. The footpath creates a safe environment for relatives to take people for a walk away from the everyday surroundings of the home. The laundry facilites on both Kendal and Derwent Suite had been fully upgraded and refurbished taking into account maximum Infection Control procedures. The standard of hygiene and cleanliness throughout the facilities was extremely high with the manager confirming that all staff had participated in up to date Infection Control training. It is important that good health and hygiene standards are maintained at all times in order to minimise the potential risk to people using the service. During the recent very warm weather the provider of the service had installed air cooling systems at various points around the buildings to ensure the comfort of people using the service. 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 were being supported by sufficient numbers of appropriately qualified and experienced staff that enabled peoples needs to be met in the most appropriate ways. Evidence: We looked at staffing rotas and they indicated that enough staff were deployed on both Derwent and Kendal Suites to meet the current needs of people using the service. Staff spoken to confirmed that staffing levels were good and that peoples care needs were always met. There was also good levels of ancillary staff that enabled nursing and care staff to dedicate their time to meeting peoples care needs. We looked at the personnel files of a number of staff recently employed and found that all recruitment and pre-employment checks had been satisfactorily completed including enhanced Criminal Record Bureau (CRB) checks. Evidence was seen that the most recent members of staff employed were in the process of or had recently completed the Skills for Care Induction modules based on the Common Induction Standards. Training records were available to demonstrate that regular training takes place for all grades of staff and this was confirmed by those staff spoken to. Mandatory training for staff included Manual Handling, Infection Control, Basic Food Hygiene, Health & Safety Care Homes for Older People Page 22 of 28 Evidence: Awareness and Fire Safety. Other training provided included, Dementia care and the Mental Capacity Act, First Aid training and Protection of Vulnerable Adults (POVA). Those staff with the responsibility for administering medicines in the home had also received appropriate training in this. The manager told us that more than 64 of staff had achieved a National Vocational Qualification (NVQ) Award at Level 2 or above. It is important that all staff receives appropriate training to enable them to carry out their roles safely and effectively and to meet the needs of people using the service in the best ways possible. People living in the home told us, We are very well looked after, Great staff, nothing too much trouble and Staff are wonderful, its home from home here. 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 receiving a service benefit from having the support of a manager and management team with skills to provide a high quality service with procedures in place to promote their interests and well being. Evidence: The registered provider and the registered manager had an excellent working relationship and between them and the rest of the management team were constantly driving the service forward with the people that live in the home being at the centre; ensuring their needs, wishes and care are taken into account at all times. The registered manager, deputy and assistant deputy manager had all obtained or were working towards the Registered Managers Award (RMA) and all are qualified nurses. A significant development within the management team has been the recruitment of a care coordinator, a property manager and a human resource manager. Such a strong management team has enabled the service to move forward Care Homes for Older People Page 24 of 28 Evidence: with significant improvements being made within the last 12 - 18 months. All staff spoken to were very complimentary about the management team and how well supported they felt. People living in the home were very happy with the care they received and were full of praise for all levels of the staff team. Good evidence was available to suggest that people using the service and their families/relatives had regular opportunities to comment on delivery service. This was done by way of service user questionnaires and regular meetings held in the home. The manager also sent questionnaires to healthcare professionals, including GPs, Disctrict Nurses and Social Workers. We examined a number of responses and found them all to be very favourable of service delivery. All senior management staff had clear information available to them about their roles and responsibilities, including the policies and procedures that must be followed. This was further enhanced by the business plans developed by the owner who ensured that the plans linked to key strategies and objectives for the service. The home/company was accredited as an Investor in People in October 2002 and received a Post Recognition Review in December 2008. This involved the whole service being assessed in accordance with the guidelines provided for assessors by Investors in People UK. The outcome from the assessment concluded that The Lakes Care Centre meets the requirements of the Investors in People Standard. The report was extremely complimentary about the management of the service and the continual development of both staff and service delivery. The management team are also supported by a administration manager who deals with all aspects of finance relating to people living in the home. Each person has an individual account and appropropriate records were maintained. Relatives were billed for additional services provided such as private chiropody, hairdressing and newspapers. We looked at a random selection of servicing records for aids and equipment used within the home and all were found to be up to date and appropriately recorded. 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 Care Homes for Older People Page 27 of 28 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. 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