Care Home: The Willows

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What the care home does well Care plans were detailed and person centred, this means that people receive the care and support in the way that they want. The recruitment and selection process is robust and safeguards people from harm. They carry out a pre-admission assessment of needs to make sure the home can meet the person`s care needs. They offer people a trial stay at the home to help them make a decision about moving in. They have good working relationships with other healthcare professionals such as GP`s and community nurses. They carry out quality audits to find out what people think about the care they receive. Medication systems were generally well managed. What has improved since the last inspection? The care plans had improved since the last inspection, they were much more detailed and personalised. Care plans included action for the staff to take to minimise risks to people. Additional information such as blood glucose levels were recorded in care plans. This included the action staff should take in the event of hypo or hyper glycaemia. Daily records of care were more detailed and provided information about how the person spends their day. They had introduced a life history section in the care plans, these gave information about people`s likes and dislikes and have been used to inform the care plans. They have introduced a wider range of activities, this was done in consultation with people living at the home. The manager and one other senior member of staff had attended a Dementia Care Mapping course in October 2009. The Investors in People award for Bluebell unit had been renewed in march 2010. Staff training for clinical procedures is carried out by clinical staff. Staff supervision is being provided on a regular basis. What the care home could do better: There should be a system for monitoring practice following training to make sure that staff are using safe moving and handling techniques at all times. Where people are admitted to the home at short notice a basic care plan and risk assessments should be put in place. They should make sure that all medication received in the home is signed in. Key inspection report Care homes for older people Name: Address: The Willows 1 Murray Street Salford Manchester M7 2DX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Susan Jennings     Date: 1 0 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: The Willows 1 Murray Street Salford Manchester M7 2DX 01617924809 01617089481 msandher@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Unity Homes Limited Name of registered manager (if applicable) Mrs Mary Tennant Lunnie Smith Type of registration: Number of places registered: care home 124 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following categories 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: - Old age not falling within any other category - Code OP. Dementia - Code DE The maximum number of people who can be accommodated is: 124 Date of last inspection Brief description of the care home The Willows is a detached property providing accommodation for up to 124 older people. Unity Homes Limited owns the property. The responsible individual is the proprietor, Mr Sandher, and the registered manager is Mrs Mary Smith. The home is situated in a residential area of Broughton on the major bus routes and within ten minutes drive of Manchester City Centre and internally the buildings are accessible to Care Homes for Older People Page 4 of 29 Over 65 0 124 124 0 Brief description of the care home all. Two car parks provide adequate parking for residents and visitors. The cost of the service is between £373.52 and £476.60 per week. 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 that the people who use this service experience good quality outcomes. The visit was carried out as part of an unannounced key inspection, which includes an analysis of any information received by us (the Care Quality Commission) in relation to this home prior to our visit. We also looked at other information we had about the home. Some weeks before the visit the home manager was asked to complete and Annual Quality Assurance Assessment (AQAA) to provide up to date information. We sent our questionnaires to people who live at the home, their families and staff in order to find out their views. We received six completed survey forms from people living at the home. The visit was carried out on Monday 10th May 2010 by two inspectors. The visit was Care Homes for Older People Page 6 of 29 unannounced and took place over the course of eight hours. During the course of our visit we spent time talking to people who live at the home, their relatives, the manager, the owner and several members of staff. Time was spent examining maintenance records, peoples care plans and staff recruitment files. We also walked around the building. References to us, we and our in this report refers to the Care Quality Commission. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: There should be a system for monitoring practice following training to make sure that staff are using safe moving and handling techniques at all times. Care Homes for Older People Page 8 of 29 Where people are admitted to the home at short notice a basic care plan and risk assessments should be put in place. They should make sure that all medication received in the home is signed in. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 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. In order that peoples care needs are identified and met the home carries out a preadmission assessment. Evidence: We saw that people were only admitted to the home following a pre admission assessment of the their care needs. This is done to make sure that staff are able to meet peoples needs. We saw that the pre admission document was detailed and contained information about the persons daily living needs. In addition to the homes pre-admission assessment they also received a copy of the local authority care managers assessment. We looked at a sample of peoples care plans and saw the pre-admission assessments and care managers assessments were held on file. People who are thinking about moving into the home and or their representatives Care Homes for Older People Page 11 of 29 Evidence: were encouraged to visit, have a look round, meet staff and other people living at the home. Information received in the completed comment cards confirmed that people felt that they had received enough information about the home before making a decision to move in. The Statement of Purpose is available in for people to look at. We saw copies of the Service User Guide available in each bedroom. The home does not provide an intermediate care service. 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, social and personal care needs were being met by staff that respected their privacy and dignity. Evidence: We looked at a sample of peoples care plans. We saw that they had been updated since the last inspection and were much more detailed and person centred. The manager told us that she and a senior member of staff had attended a residential course on Dementia Care Mapping. This is a method of planning support for people that focuses on the individual, their preferences choices and abilities and involves observations of what happens during the course of a day. It helps carers to identify day to day activities that can have either a negative or positive effect on the person with dementia. By understanding this a person centred care plan can be developed that helps to improve peoples experiences, health and wellbeing. The care plan and risk assessments for one person who was recently admitted to the Bluebell unit had not been completed. The pre admission assessment gave staff enough information about the persons daily care needs and we saw that detailed daily Care Homes for Older People Page 13 of 29 Evidence: records were being kept. Staff told us they were still observing and assessing the person. It is recommended that risk assessment and basic care plans are written when a person is admitted to the home with the information they have, this can be added to and further developed. The care plans contained details of peoples personal choices, preferences and care needs. For example, one persons care plan told us, enjoys supper before going to bed, can be resistive to care, a full explanation of the task going to be performed should be given at the beginning and staff should encourage to do as much for themselves as possible. Care plans gave the staff clear instructions as to how they should support a person in the way they liked to be supported. There was documented evidence that the individual support plans had been reviewed regularly, which ensures that peoples needs are being appropriately met. We saw one persons care plan that identified that the person was unable to recognise danger to themselves and others. The care plan advised staff what action they needed to take to minimise the risks to person, for example can be distracted by offering a cup of tea and leading to their room or the sensory room the care plan also informs us that the person is unable to use the nurse call and advises staff to monitor the person. One persons care plan advised staff that they preferred to be taken to the meal table toward the end of the meal when it is quieter. We saw that monthly evaluations were in place. Care plans were updated when information changed or new information was noted. For example one person who always turned their clothes inside out told staff, I do this to air them and always have done. Prior to this staff were not aware of why the person did this with their clothes. We saw care plan of people who had diabetes. These showed the record of weekly fasting blood sugars and advised staff of the action to take in the event of hypo or hyper glycaemia. Or when to contact the GP. We spoke to the relatives of one person on Bluebell unit. They were all very happy with the care and attention received. They told us that staff communicated well with them if there are any concerns. They told us all the staff here are brilliant and the one in the office is a gem, she is so helpful and supportive. Another visitor told us that their relative was admitted to the home recently. They told us that it had been a difficult time for the family and they have nothing but compliments for the way the staff at the home have made them feel and for the care they have provided. We saw that people were pleasantly and appropriately dressed. Staff spoken to said they encouraged people to choose their own clothes. People had their hair done and Care Homes for Older People Page 14 of 29 Evidence: staff enjoyed washing and setting peoples hair as necessary. Some people had finger nails painted and these were kept short and clean. We spoke to people living at the home and visitors who told us that staff treated people with respect and dignity. One relative said that from their observations whilst visiting the home peoples privacy and dignity was always respected by staff. We saw that where people needed support staff were sensitive, kind and considerate. We saw that people living at the home and staff had a good working relationship and there was a great deal of lighthearted banter between them. We saw that people were registered with a local general practitioner and that community nurses visited the home on a regular basis. They told us that people had access to a dentist and optician as and when required. We looked at the homes medication administration systems. We saw that procedures relating to safe storage, administration and recording of medication were in order. We carried out a visual check of the blister packs and a random count of boxed medication which were found to be correct. Recording of doses administered were accurate and the correct coding had been used where medication had not been administered. We saw that two peoples medication on Bluebell unit had not been signed into the home, although the numbers of tablets did match with the number administered. We saw that staff who are responsible for administering medication had received appropriate training. This is to make sure that people responsible for administering medication have the appropriate skills and knowledge. Care Homes for Older People Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities are provided and a variety of well balanced meals are provided. Evidence: We saw that some of the care plans included detailed life histories which were well written. We saw that family members had been encouraged to contribute to these. We saw that there is a varied and flexible programme of activities. This means that people are able to choose which activities they want to take part in. Activities included one to one activities such as manicures for people who did not wish to participate in group activities. This was confirmed by people spoken to. We saw that some of the activities included a singer, weekly religious services, quizzes and a cookery class. They told us that the cookery class was very popular and promoted lots of discussions. They also told us that the cookery class had been a learning experience because people living at the home had shown some of the younger staff how to make a cake from scratch rather than from a packet. We saw lots of photographs of birthday parties, arts and crafts sessions and the cookery class. The lounge areas offer people a pleasant and easily accessible area for people to come Care Homes for Older People Page 16 of 29 Evidence: together. People can sit and watch television or participate in planned activities. They told us they were involved in fund raising ventures for example they are taking part in a sponsored walk for charity in Albert Park. They told us they take a picnic to the park for after the walk and make it a big event. The care plans we saw contained information about past hobbies and interests. One person had a section named welcome to the past and present life of. This gave details of the persons life, significant people and events, hobbies and interests as well as spiritual and religious needs. This makes sure that all needs are identified and met. Care plans documented peoples personal preferences around their day to day lives and people were free to access their rooms or the communal areas without any restrictions. We saw that staff were painting with some people, a large number of people on Bluebell unit were in the lounge doing a quiz together in the morning. In the afternoon downstairs staff supported people to sing along with a karaoke machine. They were clearly enjoying themselves and a number of other people joined in moving to the music and applauded people who were singing. The atmosphere was happy, calm and people were seen having some fun together. We saw that people were encouraged to maintain contact with family and friends. They told us in the AQAA that visitors were welcome at any time. We spoke to visitors who confirmed that staff were always welcoming. We saw one persons visitors had brought in fish and chips and sat with their relative in a quiet corner to enjoy these together. There were a number of compliment and thank you cards on display. One persons son wrote in Jan 2010, on each unannounced occasion we have found staff sitting with people in the lounge, talking and caring for those people, I am always made welcome, offered tea and biscuits to share with Dad in the privacy of a separate lounge. Another person wrote, thank you for taking such good care of my aunt and another thank you for all you did when he was unwell I was comforted to know of your care and support. People told us that there is a choice of meals and drinks and snacks are available throughout the day. The meals are prepared in the main kitchen and served in the dining rooms in accordance with peoples preferences. The dining areas offered people a pleasant environment to enjoy their meals. We saw staff gave one person an ice cream cone because she felt like one. Care Homes for Older People Page 17 of 29 Evidence: We saw the midday meal being served. Staff were observed helping those people who needed support with eating their meal. We saw this was done in a sensitive manner, staff sat beside the person and the person was not rushed. We saw that people were offered choices and that meals were well presented and of ample portions. We saw that very little food was returned to the kitchen. People told us that the meals were always nice. They told us that a new sweet menu been developed by the chef with peoples input about their own favourites. These included home made cakes and pastries and scones with jam and cream. The manager and a senior member of staff have completed a Dementia Care Mapping course. Training sessions have been arranged to help staff understand the specialist needs of people with dementia. Care Homes for Older People Page 18 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. People are able to raise concerns and be confident that they will be listened to and acted upon. Evidence: We saw that they have a complaints procedure, which is included in the Service User Guide and each person has been given a copy. We received six completed survey forms. People told us that they knew who to speak to if they were not happy. One relative told us I have no doubt they would take my concerns seriously and look into them another told us I have never had cause to complain but if I did would speak to one of the staff or the manager and feel sure they would act appropriately. We spoke to staff who knew what to do if somebody wanted to raise a concern or complaint. One relative spoken to said they knew how to make a complaint but had never wanted to, they said they were more than happy with everything at the home. The manager kept a record of all complaints and compliments received by the home. We saw that complaints had been appropriately recorded and investigated. The manager told us that the owner is informed of any complaints received. This means that complaints or concerns are used to improve the service and make sure that poor practice is identified and addressed. We saw that they had a copy of the Salford joint agency safeguarding policy and Care Homes for Older People Page 19 of 29 Evidence: procedure. The manager was able to clearly describe the actions to be taken in the event of an allegation of abuse being made. The manager told us she had been made aware of a recent safeguarding issue and made a referral using the local procedures. The investigation relating to this incident was ongoing. They told us that to make sure that people living at the home were protected from harm or abuse, safeguarding was included as part of the induction. Care Homes for Older People Page 20 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. People live in a clean comfortable and pleasant environment. Evidence: The home was very spacious and allowed people to enjoy the communal facilities available. In The Willows there was a smoke room, a smaller television room, a dinning room, a sun lounge and a larger lounge with a music facility. People were able to chose whether to go to the television room to watch television or to the large lounge to listen to some music. The communal areas were well planned, bright and well decorated. We walked around the home and looked at a sample of bedrooms. Bedrooms had ensuite facilities. They were well decorated and personalised with peoples own possessions around them. Each bedroom had a comfortable chair in it. All bedrooms had adequate furniture for peoples use. These included photographs, pictures, items of furniture. We saw staff encouraging people to talk about their family members and their interests. We saw that the home has a call bell system with access in every room. All bedroom doors in Bluebell Court also have a contact door alarm which can be activated to alert staff immediately if a person is at a risk when leaving their room. We received Care Homes for Older People Page 21 of 29 Evidence: completed survey forms from six people living at the home. There were sufficient toilets situated around the home. They were clearly marked and close to the communal areas and bedrooms so that residents could access them easily. Furniture was of a domestic nature and of a good standard. The home had a programme of routine maintenance and renewal of the fabric and decoration. The home was clean and tidy and odour free. Five people told us the home was always clean and fresh, one person told us it was usually clean and fresh. We spoke to visitors to the home. People told us that the home was always clean and tidy and that they had not noticed any unpleasant smells. We saw that equipment and adaptations were provided to assist people with limited mobility these included grab rails and assisted bathing facilities. People who required additional equipment such as a walking frame would be referred to a physiotherapist for assessment. There were a number of lounge areas for people to sit and watch television, listen to the radio of sit quetly. They have increased the number of small lounges, including a quiet lounge. It was good to see that people had a choice of where they wanted to sit and who with. People appeared to enjoy sitting in small groups and there was evidence of people interacting with each other. The smoking lounges on each unit were in need of re decoration. They told us that these areas were re decorated more than other areas in the home but that they soon looked drab again. We saw liquid soap and paper towels were in use in toilets and bathrooms, staff had access to latex gloves and plastic aprons and sanitising hand gel was available. All of these help to reduce the risks of infection. Care Homes for Older People Page 22 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. Peoples care needs are met by the numbers and skill mix of staff. Evidence: We saw a sample of staff files. We saw that these were well maintained and contained all the necessary checks. We saw that Criminal Records Bureau (CRB) checks and checks had been made with the Independent safeguarding Authority (ISA). All applicants have at least two references and, when possible, one from their last employer. We saw that all staff completed an induction period. We saw that supervision gave staff an opportunity to discuss their training needs and identify further training that would be of benefit to the people living at the home. We saw that all staff received a copy of their job description detailing their roles and responsibilities. The home keeps individual records of training and updates these after each supervision meeting. They told us that the organisation has a training manager and a programme that includes training such as Protection of Vulnerable Adults, Health and Safety, Manual Handling, Basic First Aid, Skills for Care Common Induction, Dementia Training and Continence Care. We spoke to staff who told us that they had access to training. Care Homes for Older People Page 23 of 29 Evidence: We saw that there was a mix of male and female staff so that people can choose to have a male or female carer. One member of staff told us the home provides individualised care to each individual resident. We observed staff attending to two people who were getting annoyed with each other. The staff member intervened and de escalated the situation in a calm, effective manner to distract the two people. We observed staff helping one person to stand from a chair by using an under the arm drag lift. One member of staff told us we are not told to use a hoist, however, another member of staff told us we use the standing hoist. It is recommended that staff are monitored following moving and handling training to establish they follow the practice at all times. Staff told us that sickness has reduced, there is a stronger team spirit and staff commented they felt they were letting their colleague down if they are off sick. Care Homes for Older People Page 24 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 managed in the best interests of the people living there. Evidence: The manager is a registered nurse, she has the necessary experience and knowledge to manage the home in the best interest of the people living there. We spoke to staff who were complimentary about the manager. A visitor told us the manager is approachable and always available to speak to, they keep me up to date with mums care. Staff told us that they received supervision about every three months, on the job supervision on a day to day basis and an annual appraisal. We spoke to a number of staff at the home all of whom told us that they were supported by the manager. One person told us I usually work nights but if I needed to speak to the manager I would just ring her and tell her and she would either stay late or come in early to meet with me and the manager is very supportive and always available. Care Homes for Older People Page 25 of 29 Evidence: We saw that policies and procedures were in place with regard to managing peoples finances. They told us that the financial records had been audited by social services recently and there were no concerns about the way in which peoples finances were managed. We saw a sample of financial records, receipts were kept for all transactions made on behalf of people living at the home. These showed us that peoples financial interests are safeguarded. The opinions of the people living at the home, relatives, visitors and staff were sought through meetings and face to face contact. In addition we sent survey forms to people living at the home. The information provided in the AQAA demonstrated that the homes maintenance certificates and records were up to date. Evidence was seen that fire safety checks were regularly undertaken to ensure that people are not put at any unnecessary risk. We saw that a health and safety policy was in place and risk assessments of the premises and safe working practices had been carried out. This was to make sure that people living at the home and staff had relevant information to enable them to live and work in a safe environment. We saw that there are procedures in place, such as weekly fire safety checks, safe systems of work, health and safety checklists and routine maintenance checks. We looked at a sample of accident records completed Jan 3 , March 8 and April 3. We saw that these were appropriately completed and the information entered in the daily records. They carried out a quality audit. This is to monitor the performance of the home in areas such as accident reports, medication storage and administration, staff training and health and safety. They told us they are planning to carry out quality surveys and will use the results to improve the service further. Monthly meetings are held with people living at the home. These covered the way the home is run and the quality of care provided. Feedback from relatives and friends was all very positive about the home. One person said I dont know what would we do without places like this. Another said I am confident that my relative is safe and well cared for, I have no worries about them being here. 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 7 It is recommended that risk assessment and some care plans are started when a person is admitted to the service with the info they have to date, this can be added to and developed. It is recommended that a more robust method of auditing medication systems to make sure that medication received by the home is signed for. It is recommended that staff are monitored following moving and handling training to establish they follow the practice at all times. 2 9 3 30 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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. 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