Care Home: The Lodge Nursing Home

Similar services:

• Byars Care Home
• St Marys Nursing Home
• Bramble Lodge
• Parkmanor Residential Home
• Thornham Grove
• Hunter`s Lodge
• London Road Neurological and Specialist Care Unit
• Carlton Care Home

What the care home does well we found many positive comments about the home. These incuded, One of the most pleasant and clean homes I have visited. Mum is always well cared for in every possible way. Staff always take time and are helpful. I always enjoy the meals. People are well informed about the home and its services and their needs are suitably assessed before they move there. Peoples health care needs are well met from staff that treat them with respect and promote their dignity and privacy. And their rights to inclusion in their care and treatment are being more effectively promoted. The provision of activities and meals for people, together with their individual lifestyle preferences and daily living choices are mostly determined in consultation with them and usually to their satisfaction. Complaints are taken seriously by the home and acted on in a timely manner. And people are protected from harm and abuse by the home`s procedures and training arrangements for staff. The service is usually proactive in promoting a safe, clean and comfortable environment, which suits peoples needs. People may continue to be assured that their needs will be met from staff that is effectively recruited, inducted, trained and deployed. The home is very well managed in peoples best interests. And their health, safety and welfare promoted and protected. What has improved since the last inspection? A revised format and approach to individual needs risk assessment and care planning is in process of being introduced to account for national and good practise developments in this area. Record keeping for the the administration of peoples medicines is well kept and in accodance with good practise. People have been consulted as to their satisfaction with meals and provided with clearer information as to the daily menu provision. The dedicated staff hours for the provision of social and recreational activities for people have been increased and people are being effectively consulted and engaged in their development. All staff have the information they need about the role of outside agencies in safeguarding procedures and when to contact them.Improvements in the environment continue via the homes ongoing and targeted programme of maintenance, repair and renewal. They have also complied with previous requirements that we made at our last inspection about specified equipment repair and laundry storage arrangements. Sickness and absence monitoring is more proactive and comprehensive learning and development information is provided for staff. Results of satisfaction surveys conducted with people about the quality of care and services they receive are now published and displayed in the home. Policy and procedural guidance for the Mental Capacity Act and Deprivation of Liberty Safeguards 2009, has been developed (which is to be rolled out to staff along with training and instruction). What the care home could do better: Ensure that the revised needs assessment and care planning format is fully introduced for each resident within a limited timeframe. Review the practise of seating people to the table in the wheelchairs they are transported to the dining room in. And preferably in consultation with each person where possible. So as to promote their individual choice for their seating in a suitable type dining chair. Ensure that the number of care staff achieving at least NVQ level 2 in care continues to increase, beyond the current fifty percent, with the aim of working towards a majority of care staff having achieved this. Review the homes induction process and recording format so as to ensure it matches with nationally agreed specification, such as those outlined by Skills for Care. The roll out of the homes policy and procedures relating to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards 2009 should be effected as soon as possible. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Lodge Nursing Home Hayfield Road Chapel-en-le-frith Derbyshire SK23 0QH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Susan Richards     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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: The Lodge Nursing Home Hayfield Road Chapel-en-le-frith Derbyshire SK23 0QH 01298814032 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) : thelodge100@btconnect.com Union Healthcare Midlands care home 36 Number of places (if applicable): Under 65 Over 65 36 old age, not falling within any other category Additional conditions: 0 1. The registered person may provide the following category/ies of service only: Care home with Nursing Code N 2. The maximum number of service users who can be accommodated is: 36 to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category Code OP Date of last inspection Brief description of the care home The Lodge Nursing Home provides nursing and personal care and support for up to thirty-six older persons, both male and female. It is located on the outskirts of Chapel en le Frith, a small town in the High Peak area to the north of Buxton. The home is a large Victorian building of substantial character, which has been extended and provides accommodation over three floors accessible via a shaft lift and stairs. The environment is suitably adapted and there is a range of adaptations and equipment provided to assist those who may have mobility problems. There is a choice of lounge space with a large dining room and conservatory also provided to the ground floor. There is level Care Homes for Older People Page 4 of 29 Brief description of the care home access to well kept gardens, which provide seating and a car parking area. All rooms have a sink provided, with some having en suite toilet and washing facilities. There is a range of communal bathing and toilet facilities provided, which are suitably located. The home is staffed with a team of nursing, care and hotel services staff, including an activities co-ordinator and full-time administrator that are led by the registered manager, Dawn Winfield appointed since our previous key inspection to this service. External management support is also provided. A copy of the most recent inspection report is openly displayed along with a variety of information about the home in the main reception area. Fees charged are as follows: 460.30 pounds - 680.00 pounds per week. Actual fees charged are determined in accordance with individuals assessed needs. For those who may be eligible, these may include contributions from either local authority funding for personal care and accommodation or primary care trusts for any free nursing care element of the fee. Where people are not eligible to assistance with their funding, fees are agreed by way of private contract between the home and individual. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use the service experience good quality outcomes. The focus of our inspection is on outcomes for people who live in the home and their views on the service provided. The inspection process looks at the providers ability to meet regulatory requirements and national minimum standards. Our inspections also focus on aspects of the service that need further development. We looked at all the information we have received, or asked for, since the last key inspection. This included: the annual quality assurance assessment (AQAA) that was sent to us by the service. (The AQAA is a self-assessment that focuses on how well Care Homes for Older People Page 6 of 29 outcomes are being met for people using the service. It also has some numerical information about the service; surveys returned to us by people using the service and from other people with an interest in the service); information we have about how the service has managed any complaints; what the service has told us about things that have happened there - these are called notifications and are a legal requirement; findings at our previous key inspection and the results of any other visits we have made to the service in the last 12 months; relevant information from other organisations; and what other people have told us about the service. The inspection visit of 08 July 2009 included assessing compliance with previous requirements made and the meeting of key national minimum standards. We sent out a number of anonymised service user, relative/representative and staff surveys to the manager for their distribution. Although we did not receive any returns. However, the manager told us that these had not been received. There were 35 people accommodated in the home on the day of the inspection visit, including one person for a shorter period of respite care. The majority of people were receiving nursing care. We spoke with People who live in the home, visitors and staff during the visit. We were assisted by the the registered manager. (Some people were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff). Case tracking was used during our visit where we looked more closely at the quality of care and services received by 3 people living in the home. We did this by speaking to them and/or their relatives, observation, reading their care records, and talking to staff. All of the above was done with consideration to the diversity needs of people accommodated at the home. At the time of our visit there were 25 female and 10 male people accommodated, all of British white, Christian based religion. Some with dementia care needs and many with physical and sensory disabilities. What the care home does well: What has improved since the last inspection? A revised format and approach to individual needs risk assessment and care planning is in process of being introduced to account for national and good practise developments in this area. Record keeping for the the administration of peoples medicines is well kept and in accodance with good practise. People have been consulted as to their satisfaction with meals and provided with clearer information as to the daily menu provision. The dedicated staff hours for the provision of social and recreational activities for people have been increased and people are being effectively consulted and engaged in their development. All staff have the information they need about the role of outside agencies in safeguarding procedures and when to contact them. Care Homes for Older People Page 8 of 29 Improvements in the environment continue via the homes ongoing and targeted programme of maintenance, repair and renewal. They have also complied with previous requirements that we made at our last inspection about specified equipment repair and laundry storage arrangements. Sickness and absence monitoring is more proactive and comprehensive learning and development information is provided for staff. Results of satisfaction surveys conducted with people about the quality of care and services they receive are now published and displayed in the home. Policy and procedural guidance for the Mental Capacity Act and Deprivation of Liberty Safeguards 2009, has been developed (which is to be rolled out to staff along with training and instruction). What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well informed about the home and its services and their needs are suitably assessed before they move there. Evidence: At our last key inspection we judged that the homes admission and needs assessment process accorded with good practise and was in peoples best interests. In our annual quality assurance questionnaire the home told us they continue to ensure a comprehensive approach to peoples admission to the home, including for their individual needs assessment. Whether for long or short term admission there. They told us about some improvements they are introducing. Including with regard to the way they record and account for peoples risk assessed needs. At this inspection we found there were thirty five people accommodated, most of Care Homes for Older People Page 11 of 29 Evidence: whom receive nursing care. The home operates a rolling respite bed facility, which is funded and used by their local GP practise to admit people from the local community who may require only short periods of care and support. People told us that they were well supported throughout their admission to the home and received all the information they needed to help them. Many people commented that they were made to feel very welcome. We saw that people are provided with key written information about the home and the services provided there. Recorded needs assessments were in place for each person. And we saw that the home obtains key information for these before a person is admitted there, so they can be sure they can meet peoples needs before moving there. We saw that a revised method was being introduced in stages for the way the home records and accounts for peoples needs, including for their personal safety and risk. This also aims to promote a more person centred approach to determining peoples needs. And when fully introduced, will account for peoples mental capacity to make key decisions about their lives and their care and treatment in accordance with recognised guidance and legislation. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health care needs are well met from staff that treat them with respect and promote their dignity and privacy. And their rights to inclusion in their care and treatment are being more effectively promoted. Evidence: At our last key inspection we found that peoples overall healthcare needs to be well met, but that medicines administration record keeping did not best underpin accountability for practise. We made a requirement about this, which the home has complied with. In our annual quality assurance questionnaire completed by the home, they described a comprehensive approach to ensuring that peoples healthcare needs are met, which was satisfactory in principle. And also about some key service developments they have made and also planned. These included approaches to individual care planning, risk assessment and care delivery arrangements. Care Homes for Older People Page 13 of 29 Evidence: At this inspection we saw from looking at peoples care planning records and talking with them, that this work is progressing well. And we could see how the revised care planning format being introduced and revised arrangements for individual care delivery may benefit people, once fully rolled out. Staff were motivated in their work. And people who use the service told us that staff treat them with respect and promote their dignity and privacy at all times. They also told us that their care and medical needs were being met. We found that inputs from outside healthcare professionals were well accounted for in respect of those people whose care we looked at more closely. These included both for the purposes of their routine health care screening. And also in ensuring that assistance from outside health and social care professionals are sought for people when necessary. We looked the the arrangements for the ordering, receipt, storage, administration and disposal of peoples medicines, including where they may choose to retain and administer these themselves. And we found these to be satisfactory and in accordance with recognise guidance for practise. Although there was no person who had chosen to keep and administer their own medicines, we saw that there is a clear policy and procedure in place should any person choose to do so. Including for the safe storage of such medicines in peoples own rooms and in ensuring a suitable risk based approach to determining this with people. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The provision of activities and meals for people, together with their individual lifestyle preferences and daily living choices are mostly determined in consultation with them and usually to their satisfaction. Evidence: At our last key inspection here we found that people were mostly satisfied with their lifestyle experienced at the home and the food provided. Although we made a recommendation that daily menus are displayed, including alternatives to the main course, which was seen to be achieved at this inspection visit. In our annual quality assurance questionnaire that the home completed, they told us that they provide people with nutritious food and a range of social activities events to suit their needs, wishes and choices. Promoting mealtimes as a social event and continuing to develop their range of social activities and events for people. They also told us that they encourage and support people to manage their own financial affairs where possible. They also told us about some developments that they aim to make over the coming Care Homes for Older People Page 15 of 29 Evidence: months, which included developing a patio area to the side of the home with seating for people, which we saw had developed at this inspection. And also, in organising more social events at the home, which include peoples families and friends. At this inspection we found that the dedicated staff hours for organising and providing activities for people had increased to thirty hours per week and with a named activities co ordinator in post. People spoke positively about the developments in activities arrangements and told us that there are usually activities they can join in. Examples of activities that are regularly organised include, gardening club, baking club, reminscence, nail and hand care, memory book, chair based movement class, film club, bingo, comedy and art club, games and crafts. One person told us they particularly enjoyed the book club and two other people with significant sight difficulties, said they enjoyed the story book cassettes that they regularly listened to. We also saw from speaking with people and looking at activities records, that regular events are organised, such as a recent cricket day and Ascot day. And we saw a schedule of events posted for Wimbledon fortnight. Information about activities is displayed in the main entrance hall. Records of activities are kept by the activities coordinator, which include peoples enjoyment, participation and improvements suggested. With regular reviews as to peoples satisfaction with changes and improvements suggested. People told us that their views are sought about their lifestyle preferences, choices and routines. And we saw that the activities coordinator spent time talking privately with a new service user, so as to ascertain some of these with her. People also told us that they usually enjoy meals provided. The daily menu was displayed so that people could see this, in the main dining room along with five weekly rolling menus. These indicate a balanced nutritious diet is offered and with alternatives are provided to each main dish. People said they know they can always have something else if they dont wish to choose anything from the menu of the day. Lunches served were well organised, with some people eating in the main dining room and some in their own rooms. During discussions, two people told us that they chose to eat in their own rooms. Staff assisted people sensitively and enabled peoples independence where possible. Special dietary requirements were observed to be catered for. Care Homes for Older People Page 16 of 29 Evidence: However, we saw that ten out of the eleven people seated at the dining room tables, remained in the wheelchairs they were transported there in. One of those people when asked, said they had not been offered a chair seat to the table. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are taken seriously by the home and acted on in a timely manner. And people are protected from harm and abuse by the homes procedures and training arrangements for staff. Evidence: At our last key inspection we found that peoples rights to complain and to be protected from harm and abuse were upheld and taken seriously. Although we made a requirement to develop the homes written procedures to ensure that staff were familiar as to how to contact the leading local authority concerned with these. We found this to be met at this inspection. In our annual quality assurance questionnaire completed by the home. They told us that people are informed as to how to complain. And that they ensure all complaints are effectively handled. Providing staff with the training and information to safeguard people from harm. They also told us about improvements they aim to make over the coming months, which include training for staff in respect of the Mental capacity Act 2005 and Deprivation of Liberty safeguards 2009. Which we have referred to under the Staffing and Management sections of this report. Care Homes for Older People Page 18 of 29 Evidence: They gave us some information about complaints that they have received. And at this inspection we found that comprehensive records are kept for these. Including details as to their investigation, findings and any action taken as a result. Over the last 12 months the home has received three complaints directly, including one that they reported to and was investigated via joint agency safeguarding procedures. The Commission has received two complaints about the home, which we referred to the provider for their investigation within the remit of their complaints procedure. None of the complaints were fully substantiated. However, complaints records tell us that the home has taken satisfactory action where there were any matters arising from their investigation and to the satisfaction of all parties. People told us that they know who to speak to if unhappy and most said they knew how to make a complaint, although one person was unsure. However, we saw that a copy of the homes complaints procedure is displayed and that information about how to complain is provided within the service guide for people. Staff that we spoke with said that they were able to access training and updates in safeguarding people from harm. And were conversant with procedures to follow in the event of witnessing or any suspicion of the harm or abuse of any service user. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is usually proactive in promoting a safe, clean and comfortable environment, which suits peoples needs. Although appropriate consultation regarding key environmental changes may be in peoples better interests. Evidence: At our last key inspection here we found that overall people lived in a safe, clean, homely and generally well maintained home that suited their needs. We made a recommendation that the mechanical sluice be kept in a good state of repair. This was found to be in working order at this inspection. The completed AQAA told us that people continue to be provided with a safe, clean and well maintained home. Information was also provided about improvements made and also aimed for over the coming months. These focus on the ongoing maintenance, upgrading repair and redecoration of the home, with key action plans indentified via an internal environmental auditing system. We saw at our visit, where some of their action plans were completed, including for the provision of new areas of carpeting, redecoration of some residents rooms and development of an outside patio and seating area for people. At this inspection people told us that the home is always kept fresh and clean and that Care Homes for Older People Page 20 of 29 Evidence: their own rooms are comfortable, with their own personal possessions and equipment that they need. Areas of the home that we looked at were clean, odour free and well maintained and decorated and free from any observable hazards. However we saw that the first floor lounge for residents had been converted into an office for the manager and adminstrator. This means that there is now only one ground floor lounge and a separate dining room for residents use. With no choice of lounge space for people. Discussions with the manager told us that consideration was not given to consulting with people about this change before it occurred, or in determining whether the change would affect the minimium communal space requirements for each resident as stated in the Department of Health National Minimum Standards in care homes for Older People. The manager advised us of a recent visits from outside authorities concerned with the environment and provided copies of their reports from these. They include the Environmental Health Officer, who gave an excellent rating for their kitchen inspection. And the Fire Officer from Derbyshire Fire and Rescue Authority who reported satisfactory findings from their inspection. An infection control audit had also been recently undertaken by the lead infection control nurse from the local primary care trust. With an overall 74 percent outcome score. An action plan was in place to address matters arising from that audit and with further infection control training planned for staff in the near future. Suitable infection control guidance was provided for staff, together with procedures for dealing with spillages. And staff were provided with the necessary protective clothing for their duties. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People may continue to be assured that their needs will be met from staff that is effectively recruited, inducted, trained and deployed. Evidence: At our last key inspection we found that peoples needs were well met from competent staff that were suitably recruited, inducted, trained and deployed. The home told us in the AQAA that they continue to ensure effective staffing arrangements with fifty percent of staff having achieved NVQ level 2 or above. They told us about some improvements they are making, which include more robust sickness and absence monitoring for staff and for keeping staff informed as to training arrangements and opportunities. They also gave us some statistical information that we asked for about staff employed and their recruitment, induction and training. At this inspection people told us that staff is usually available when they need them and that staff always listen and act on what they say. Dicussions that we held with people and records that we examined told us that there Care Homes for Older People Page 22 of 29 Evidence: are mostly effective arrangements in place for the recruitment, induction, training and deployment of staff. Although we found that records of induction were not comprehensive and that staff described differing approaches to their induction. We discussed this with the manager she agreed to review the homes induction process and record format against nationally recognised standards such as Skills for Care to ensure that they accord with this guidance. We spoke with the manager about staff NVQ training status and saw from records of staff turnover that this has impacted on the total number of staff achieving this. Staff were clear and consistent as to the homes aims and objectives and philosophy of care they seek to promote. We received a number of comments from people, including The staff are very good and are help me when needed. They are patient and respect my choices. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well managed in peoples best interests. And their health, safety and welfare promoted and protected. Evidence: At our last key inspection we found the home to be overall well managed and run, in peoples best interests. We made a requirement about the need to ensure the correct storage of dirty linen. And a recommendation to publish the results of satisfaction surveys for peoples access. Both of these were seen to be achieved at this inspection. The AQAA was very well completed by the manager. And gave us all the information that we asked for. Details were provided as to what the home does well, improvements made and being aimed for, together with how this can be evidenced. And all statistical information that we asked for was provided there, including for the satisfactory servicing and maintenance of all systems and equipment in the home. Care Homes for Older People Page 24 of 29 Evidence: At this inspection we saw that the manager and all staff work hard as a team and aim to deliver a high standard of care. With robust quality assurance and monitoring systems in place, records of any action plans and with regular reviews to ensuring a continous cycle of monitoring and review of the quality of care and service provision there. Together with an annual development plan. We saw that there has been a review and streamlining of all administration documentation and record keeping and with effective dedicated administration support provided. And also saw that the manager keeps up to date with her own learning and development and was in process of sourcing a course in Leadership and Management of Healthcare services. Staff told us about the arrangements for their supervision and support and for communication in the home, which are open, positive and inclusive. People said they were regularly consulted as to their views about the care and services they receive. And we saw that a summary of the results of a recent satisfaction survey which were displayed in the home for people to see. Surveys contained many positive comments about the cleanliness of the home, the quality of the environment, health and personal care received, meals, communication and staff approaches and relationships with people. Matters arising in terms of any improvements that people felt could be made focused on the development of activities. Developments underway are referred to under the Daily Life and Social Activities section of this report. Information provided in the AQAA tells us that the homes policy and procedural guidance for staff is regularly reviewed and kept up to date. And we saw that new policy and procedural guidance was developed in respect of the Mental Capacity Act 205 and Deprivation of Liberty Act 2009. The manager advised that this was to be rolled out to staff and with training to ensure its correct application. Although dates for this to be effected were not determined. Staff described suitable arrangements for ensuring peoples health and safety in the home, including by way of training arrangements, accident and incident reporting systems and provision of equipment. And records that we looked at reflected this. Although staff felt that that further improvement could be made by providing an additional standaid for moving and handling people. The manager advised that this was in hand to be provided. Care Homes for Older People Page 25 of 29 Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 The revised format for individual needs and risk assessment and care planning, including for the assessment of peoples mental capacity should be fully introduced within a limited timeframe. A review of the practise of seating people to the table in the wheelchairs they are transported there in should be undertaken and preferably in consultation with each person where possible. So as to promote their individual choice for their seating in a suitable type dining chair. It should be ensured that the number of care staff achieving at least NVQ level 2 in care continues to increase, beyond the current fifty percent, with the aim of working towards a majority of care staff having achieved this. The manager should review the homes induction process and recording format so as to ensure it matches with nationally agreed specification, such as those outlined by Skills for Care. The roll out of policies and procedures relating to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards 2009 should be effected as soon as possible. 2 15 3 28 4 30 5 33 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!