Care Home: The Priory Rest Home

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What the care home does well The Priory provides a homely environment with dedicated staff and a welcoming atmosphere. The home is set in beautiful gardens that are on level ground and easily accessible. People interested in moving to the home have an assessment of their needs before a decision is made about whether or not The Priory would be a suitable place for them to stay. Everyone has a person centred plan of care and each person is involved with the care planning process. The care plans are monitored and kept under review. People said that they receive the care they need and that staff are very kind and helpful. There is a programme of activities and people are provided with a healthy and nutritious diet. People know what to do if they have a concern or complaint and their views about the home are sought and listened to. The recruitment procedure is thorough to make sure that people are protected. There is an induction and training programme so that staff have the knowledge and skills they need to do the job. The manager has an open door policy and is very involved in the day to day running of the home. Comments that people have made about the home in the surveys include: `The staff are very kind and pleasant to all the patients`, `Always someone there to listen to your concerns and available to help`, `The home is consistently kind and caring to my elderly relative. Carers speak gently and patiently to residents`, `warm welcome for visitors`, `I cannot speak highly enough about the staff who do a very difficult job of work`, `Staff always appear to treat all residents with respect and dignity, kindness and patience` and `I think the staff work extremely hard at The Priory Rest Home to cater for the resident`s individual needs`. What has improved since the last inspection? The manager and staff have introduced person centred care plans so that people`s individual needs are noted and provided for. The home is no longer run in separate units which means that the dining room and communal areas have been opened up for all to use. A new, larger lift has been fitted. This work took several weeks and was well planned and organised to cause minimal disruption to people living in the home. What the care home could do better: The Statement of Purpose is due to be re-written to reflect the type of service that the home now provides. The advice of the environmental health officer should be sought regarding safety catches for windows on the first floor. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Priory Rest Home South Street Tarring Worthing West Sussex BN14 7NH     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: Annette Campbell-Currie     Date: 1 0 0 6 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 30 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 30 Information about the care home Name of care home: Address: The Priory Rest Home South Street Tarring Worthing West Sussex BN14 7NH 01903237027 01903204253 priory@fieldlane.org.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) : Field Lane Foundation care home 42 Number of places (if applicable): Under 65 Over 65 0 42 dementia old age, not falling within any other category Additional conditions: 42 0 The maximum number of service users to be accommodated is 42 The registered person may provide the following category of service: Care home with nursing (N) 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 (OP) Dementia (DE) Date of last inspection Brief description of the care home The Priory is a care home which is registered to accommodate up to forty one older people who also have dementia. It provides personal and also nursing care for some people. The Priory is a detached two storey property which provides accommodation in single bedrooms located on the ground and first floors. A vertical passenger lift provides access to all floors. Dining rooms and lounges are located on the ground floor. There are secluded gardens and a patio area surrounding the property which residents can Care Homes for Older People Page 4 of 30 Brief description of the care home enjoy. The property is located in the village of Tarring on the outskirts of Worthing. The fee levels range from £419 to £700 per week. Additional charges are made for the following services: chiropody, hairdressing, and some therapies provided by outside agencies. The registered provider is The Field Lane Foundation, who has appointed Mr Jeremy Lamb to be the responsible individual and to supervise the overall management of the care home. Mrs Allena Edwards is the registered manager, who is responsible for the day to day running of the care home. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who use the service experience good quality outcomes. The previous key unannounced inspection was carried out on 13th June 2007 and an annual service review (ASR) was carried out on 21st May 2008. We (the Commission) carried out the site visit over seven hours. Mrs Edwards, the registered manager and the deputy manager assisted with the inspection. Two senior managers were also available for discussion. The information and documents required by us to make an assessment of the service were available. There were thirty-eight people living in the home at the time. The home now only admits people who have a Care Homes for Older People Page 6 of 30 diagnosis of dementia. No one currently living in the home has been assessed as having nursing needs. The manager completed an annual quality assurance assessment form (AQAA) before the inspection. The AQAA provided some good information about the service and how they achieve good outcomes for people. The information was used to help plan the site visit. We sent out surveys to find out what people think about the home. Fifteen people living in the home returned surveys, some with the help of relatives; five staff and two health and social care professionals who know the home also returned surveys. Two people living in the home were spoken with, two relatives and three members of staff. We saw the communal areas including the day service facilities, the kitchen, laundry, bathroom and toilet facilities and a number of bedrooms. The following documents were read: the case records for three people living in the home, other documents relating to peoples care, the complaints policy and procedure, recruitment records for three recently appointed staff, training records, a sample of medication records, quality assurance documents and Regulation 26 reports. Time was spent in the dining room at lunchtime and we observed a handover session when the afternoon shift began. The outcomes for people living in the home have been assessed in relation to twentyone of the thirty-eight National Minimum Standards for Care Homes for Older People; including those considered to be key standards to ensure the welfare of people living in the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 30 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 30 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 30 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 have their care needs assessed before a decision is made about them moving to the home. Evidence: The Statement of Purpose for The Priory is being reviewed and updated to ensure that it accurately reflects the services provided at the home. The annual quality assurance assessment (AQAA) states that the pre-assessment process includes written documents and a day assessment which helps the home to gain a better insight into the persons needs. The person is also better placed to make an informed choice about the home. The manager explained that relatives or social workers arrange for the person to spend the day at The Priory so that an assessment of their needs can be carried out. Care Homes for Older People Page 11 of 30 Evidence: A senior member of staff spends time with the person over the course of the day with a focus on what the person is able to do as well as what their care needs would be. The manager said that relatives sometimes find it difficult to leave the person for the day but the home has found that a more realistic picture of the persons needs is gained from them visiting The Priory rather than staff visiting them in their own home or hospital. The manager said that there have been occasions when a person has been temporarily discharged from hospital for a day so that they can spend the time they need in the home. During the day people have an opportunity to take part in activities such as music therapy to help them relax. People have lunch and tea in the home and at the end of the day staff provide feedback to the person carrying out the assessment. The day gives the person the opportunity to see if they like the staff and the home. The home then provides feedback about the assessment to the person, the relatives and social worker involved. If there have been particular issues or problems during the day this would be discussed with the person and their relatives. The manager said that the home is now only admitting people who have a diagnosis of dementia. The manager said that the home sometimes admits people in an emergency situation but as much information as possible is obtained first. Mrs Edwards said that when a decision has been made that the person will move in, the relatives are asked to help prepare the room that has been chosen, so that there are some familiar items already there to help the person to settle in. We (the Commission) looked at the case records for three people and we read samples of pre-assessment forms. The assessment detailed all aspects of the persons physical, emotional, spiritual and personal care needs. Nutritional assessments were also on the case files. There was information about the persons background and lifestyle before coming to the home. The key people in the persons life were noted with their names and their relationship to the person. Peoples spiritual needs and wishes after their death were also noted. People who returned surveys indicated that they receive the care that they need which shows that the home is able to meet their assessed needs. The Priory does not provide intermediate care however respite care can be arranged. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and personal care needs set out in a person centred care plan that is kept under review. The medication policies and procedures protect people in the home. People are treated with respect and their right to privacy is protected. Evidence: The manager said in the AQAA that a new format is being introduced for person centred care plans so that all information is in one document. Staff have training in person centred care planning to make sure that they understand the concept. People are encouraged to take part in completing their care plan and person centred plan so that people are encouraged to remain as independent as possible and care plans show a true account of each person. We looked in detail at the case records for three people including one person who had recently moved to the home. The information for most people was well organised in six different files and the deputy manager said that the information will soon be organised into one large file so it is easier to access. Care Homes for Older People Page 13 of 30 Evidence: The records that we saw were person centred and individualised. There was information about the way that people prefer their personal care to be provided, for example: Although I need help to wash I do like to help dry myself, I am unable to help with getting dressed and undressed. You will need to explain to me what you need me to do and for another person: I can go to the toilet by myself - if I need help I will ask. The manager said that people have a choice of male or female carers to support them with personal care and their preference would be noted in their care plan. There was information about peoples backgrounds and previous lifestyle including their careers, so that staff know what is important to the person. The manager said that families contribute to this information as well as the person themselves. Peoples likes and dislikes were noted, including the food they prefer. Peoples health care needs were documented and for one person with a medical condition, staff had been provided with guidance about treatment and also photocopies of information about the condition so that they would understand the cause and symptoms. Other guidance provided for staff included: I need regular check ups for ear problemsand I need my eyes bathed daily. Staff had recorded this in the daily record sheets. Nutritional assessments are carried out and if there are concerns about peoples weight loss then an action plan is put in place. People are weighed every month and the home has scales that are suitable for the people in the home. Fluid or nutritional intakes are monitored and charts kept in peoples rooms if necessary, for staff to complete, we saw samples of these forms. Risk assessments are carried out for all aspects of possible risk to the person in the home. The documents are noted as functional capabilities so that peoples strengths are emphasised rather than their difficulties. The Waterlow assessment is used to monitor peoples skin integrity and mobility risk assessments are carried out. The home has set up a falls management plan so that when people are at risk of falling a clear strategy is put in place. Care plans and risk assessments are kept under review however it was not clear from the case records we saw that this is happening every month. People who returned surveys indicated that they receive the care that they need. Information about any changes in need were discussed at the handover meeting and staff spoken with said that the information they need about people is in their care plans. They said that they are kept up to date by senior staff and would report any concerns about peoples Care Homes for Older People Page 14 of 30 Evidence: welfare. Peoples mental well being is noted and monitored, for example: People should not show aggression around me as I get frightened - I need to take my time and I dont want to feel alone or isolated - encourage X to be around others. The manager gave an example of staff supporting someone who was presenting some disturbed behaviours when she moved to the home. Through observation and careful assessment some triggers to this behaviour were identified and strategies put in place so that the person is more settled and content. We saw the records and guidance for this person. The manager said that the home has good support from the local primary care team and district nurses provide a service to people in the home who are not assessed as needing twenty-four hour nursing care. The local community mental health team also provide support and guidance when there are concerns about peoples mental health or when there are behaviour issues. There were records of visits from the general practitioner (GP) with any guidance that may have been provided. No one living in the home is able to self medicate. There are lockable facilities for medication in peoples rooms. The nurse on duty or trained senior staff administer medication. If people are in their room this is done in private. Samples of the medication records were seen to be in order. The nurse on duty said that she attends training as required to keep her knowledge and skills updated. Staff are given guidance and information about the way to provide personal care as part of their induction. Staff also said that the training in person centred care planning had given them better insight into providing care in a sensitive manner and the importance of asking people how they prefer things to be done and explaining what they are intending to do to support them. Staff were observed treating people with sensitivity and respect during the day. Care Homes for Older People Page 15 of 30 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 are supported to have the lifestyle that they choose and that suits them. People are supported in their contact with relatives and friends. There is an emphasis on supporting people to access community facilities. The standard of food provided is excellent. Evidence: The manager said in the AQAA that people have a choice of activities to take part in during the day. There is a dedicated team of two day care staff who arrange individual and group activities for people to take part in. At the moment activities tend to be arranged during the day and the management team said that they are looking at ways to improve the range of activities that people can take part in each evening, for example going out to the pub or making use of other community services or events. There is a day care facility on the first floor which is a self contained area that is also well used by people to spend time with their families. There is a kitchen, two lounges and a hairdressing room for people to use. The management team have a strong philosophy of making sure that people maintain their community links and also to provide a person centred service so that people can be supported to choose the Care Homes for Older People Page 16 of 30 Evidence: lifestyle they prefer. People living in the home all have bus passes so that they can get out as often as they wish to with staff support. The case records that were seen showed that plenty of information is gathered about peoples backgrounds, careers and interests to help staff to plan a service that meets each persons individual need. People are supported and encouraged to take part in activities around the home if they wish to; this would be part of their care plan. The kitchen is also available to people with staff support and examples were given of opportunities people have to help prepare a meal or bake cakes. The kitchen on the first floor is also well used by individuals and their families. The case records that were seen showed that a person centred approach has been taken to supporting people with their chosen lifestyle. One person goes horse riding and enjoyed choosing the equipment that she needed for this activity; another person has attended a lip reading course at college. People are supported to do their personal laundry, ironing, gardening and decorating. During the afternoon of the visit several people were taken out to a local park to watch a bowls match and in the morning someone living in the home and a relative entertained a group of people in the lounge by playing the accordian. People are supported and encouraged to maintain contact with their relatives and friends. Relatives of two people living in the home were spoken with and they spoke highly of the care provided at The Priory. They said that they are always made to feel welcome and kept informed of any important information. One person said that he cannot praise the staff highly enough and that they are a great to support to all the family and kind to all the people living in the home. The manager gave an example of individual support that had been given to one person who had been supported by staff to travel to see a sick relative and that this visit had given the person some comfort. During the afternoon there were several visitors and sufficient communal space for people to have some privacy. The home has a strong philosophy of supporting people to be as independent as possible and to make choices about their lives. There is a relaxed and supportive atmosphere in the home and staff spoken with were very committed to encouraging individuals in their choice of lifestyle. People can get up when they wish and retire to bed when they choose to. Some people were eating breakfast until late in the morning as this is their preferred routine. A variety of cereals were laid out for people to choose. The food provided in the home is of a high standard. There is an emphasis on good nutrition as there is a recognition that this will support people with their physical and Care Homes for Older People Page 17 of 30 Evidence: mental health. There is a varied and nutritious menu and people are offered a choice of meal at the table so that they can see what the choices are. The management team understand that for people who have a level of confusion or dementia they would be unable to make realistic meal choices before the actual meal time. Local providers are used and fresh fruit and vegetables are provided for the best nutrition. Special dietary needs are catered for and the chef is aware of peoples likes and dislikes which are also noted in their care plans. There was a choice of hot meal and lunch was being served quickly and efficiently so that there was not time for the food to get cold and everyone had a hot meal. People were being assisted to eat in a sensitive manner and most people were being talked with during the meal so that they would know what they were eating. Care Homes for Older People Page 18 of 30 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 feel their concerns and complaints would be listened to and acted upon. There are measures in place to help to protect people from abuse or harm. Evidence: The complaints policy is displayed in the entrance hall and people are provided with a copy when they move to the home. The people who were supported to return surveys indicated that they know how to make a complaint. People living in the home have access to advocacy services if they need independent support. The manager and deputy make themselves available each day and keep in regular contact with relatives so that any concerns would be dealt with quickly. There is a system for recording complaints and a policy for investigating complaints within twenty-eight days. The home has not received any complaints within the past twelve months. The home follows the West Sussex multi agency policy and procedure for safeguarding vulnerable adults. There are several copies of the new guidance available to staff. All staff have attended training in adult abuse and the staff spoken with were clear about their responsibilities with regard to reporting any concerns. There have been two recent safeguarding alerts raised by the home involving people living there. West Sussex Adult Services investigated the incidents and the home has set up additional protocols and guidance to better protect people. Care Homes for Older People Page 19 of 30 Evidence: For people who have behaviour difficulties the home is well supported by the community mental health team so that guidance can be provided if necessary. The manager said in the AQAA that with people who have behaviours that are more challenging: we work to a gentle, positive, holistic model that has a proven success rate. The management team are aware of the Deprivation of Liberty Safeguarding guidance provided by West Sussex Adult Services. Care Homes for Older People Page 20 of 30 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. People live in an environment that is usually well maintained, comfortable and clean. Evidence: The home has been opened up to combine two areas of the building that were run as separate units. This has provided more living space and one dining room that is well laid out so that it does not feel too large and busy at meal times. This arrangement has also created two further quiet lounge areas. There has been a big investment to the home this year with the provision of a new lift. The work took six weeks and a very detailed action plan was set out so that disruption to people in the home was kept to a minimum. We saw the communal areas, the bathrooms, sluice rooms, laundry, kitchens and some bedrooms. There is a programme of development for the home and the internal decoration is in good order. The communal areas are comfortable and well furnished. The gardens are very well maintained and provide a peaceful place for people to enjoy in good weather. The outside of the home is in need of redecoration, in particular some of the window ledges and frames. The windows on the first floor are in need of being cleaned. The manager should seek the advice of the environmental health officer with regard to safety catches to the windows on the first floor. Care Homes for Older People Page 21 of 30 Evidence: There are some measures in place to make sure the environment supports people with a level of confusion. Some bedroom doors are painted different colours and most people have a picture or their name on their door so they can easily recognise their room. The home has dedicated domestic staff and the home was clean with no unpleasant odours during the visit. The day service area had been well used at the weekend and was in need of some cleaning and re organising so that other people could enjoy the facility. The sluice rooms were clean and new machines have been fitted since the previous inspection. The laundry room is positioned away from the kitchen and peoples rooms. The facilities are suitable for the needs of the home but are in need of upgrading. The manager said that this is in the development plan. Staff have had training in infection control and have a good understanding of the measures they need to take to prevent the risk of cross infection. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment procedure protects people living in the home. People are supported by suffient numbers of staff who are well trained and competent. Evidence: On the day of the site visit the manager and the deputy manager were on duty. There were four care staff, a registered nurse and two activity staff who also support people with aspects of their care. People were being well supported during the day especially at lunch time when there were sufficient numbers of staff available to help people with their meal. There were also opportunities for some individual or small group activities. We looked at samples of staffing rotas that showed that staffing levels are consistent. At night there are three carers on duty and a registered nurse. The home has not needed to employ agency staff for care duties, however a number of shifts have been covered by agency nurses in the past twelve months. The manager said that it has been difficult for the home to recruit nurses and that there are now two nurses employed. The manager said in the AQAA that the home has excellent recruitment procedures in place to make sure that people are protected. We looked at the recruitment records for three staff who were recently appointed. People had completed an application form Care Homes for Older People Page 23 of 30 Evidence: and there was photographic evidence of their identity on the files. People who are short listed attend for an interview and often service users are involved in this process. Interview forms are completed to show that gaps in employment are explored and training needs identified. Samples of completed forms were seen to show that an equal opportunities approach is taken to recruitment. Two written references had been obtained and POVA First or Enhanced Criminal Record Bureau (CRB) checks had been obtained before people began work. The manager is aware of and follows the Department of Health guidance regarding employing people before the full CRB check is obtained. There is an induction and training programme in place. 80 of staff have completed a National Vocational Qualification (NVQ) award in care at level two or above. Senior staff have completed this award at level three or four. Recruitment records were seen and showed that staff have completed their induction and mandatory training. Some staff have recently attended dementia care training and working with people who present challenging behaviour. The staff who returned surveys and those spoken with on the day said that they have the training and support they need to do their job. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well run home and an efficiently managed service. Peoples views are sought and taken account of in the development of the service. Peoples finances are protected. There are policies and procedures in place to promote and protect the health, safety and welfare of people living in the home and of staff. Evidence: Mrs Allena Edwards is the registered manager for the home; there is also a deputy manager. It was clear from discussion that they work well together to ensure the efficient running of the home. They both said that they are well supported by the operations manager for the organisation and other senior staff who visit the home frequently and offer practical support when necessary. Due to financial constraints some support staff are being made redundant. Administrative support will now be provided from head office and the management team in the home will be responsible for more of the day-to-day administrative tasks. Care Homes for Older People Page 25 of 30 Evidence: The management team operate an open door policy and people said that they are very approachable. The manager and the deputy are committed to developing and improving systems to provide a good service to people living in the home. It was clear that comments received and concerns raised are dealt with quickly. The homes response to recent safeguarding investigations is an example of this. There are quality assurance systems in place and peoples views are sought through questionnaires that are circulated as well as frequent discussion. The management team keep in contact with relatives to keep them informed and also to gain feedback about the home. Examples were given of monthly contact with some families that may be extended to other people if appropriate. The results of questionnaires that have been returned have not yet been collated and provided to people to show that their views have been listened to. Regulation 26 visits to the home take place each month and a written report is provided. The outcome of the visit and any required actions are discussed with the manager. Samples of these reports were seen and covered all aspects of the service provided at The Priory. Most people have support with their finances from relatives or solicitors. Where financial support is provided by staff from the home on a day-to-day basis there are procedures in place and detailed records are kept to ensure that peoles money is kept safe. Information provided in the AQAA showed that equipment in the home is serviced as required. There is a fire safety risk assessment and staff attend fire safety training as required. There are policies, procedures and training for staff in health and safety matters. The manager should seek the guidance of the environmental health officer regarding safety catches for first floor windows in order to ensure that people are kept safe. Incidents and accidents are recorded and monitored so that risks in the home are minimised. There is a falls management programme in the home and the manager said the new process has been of benefit in supporting people who are at risk of falling. Care Homes for Older People Page 26 of 30 Care Homes for Older People Page 27 of 30 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 28 of 30 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 29 of 30 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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