Care Home: The Willows

Similar services:

• Maple Lodge
• Heathlands
• Aston Court Nursing Home
• Breme
• Ravenhurst
• Bank House
• Inspirations
• Ashcroft Hollow Nursing Home

What the care home does well Residents and relatives were almost unanimous in their praise for the service. In particular, the staff, manager and the food were singled out for praise. Typical comments were : `the staff are brilliant`, `staff are very attentive`, `the manager is always about, and helpful`, `the food is always good, and lots of it`. The home was praised for being `homely` and making all welcome. Staff were attentive to individual care needs, and assist people in a positive way that respects their dignity, handling people properly and reassuring them throughout. Several residents and relatives compared care received at the home very favourably to that received during hospital stays. What has improved since the last inspection? There have been great improvements since the last inspection. Suitable assessments now ensure that the home does not admit people whose needs it cannot meet, and care recording and planning has improved to an acceptable level. Suitable risk assessments are now in place to show areas of concern such as nutritional needs and support their effective management. Medication is now better managed, and the safety of residents is better managed, through ensuring equipment is safely maintained and used, and ensuring suitable safeguarding procedures are in place. What the care home could do better: There is still room to improve care plans, so that they clearly detail all aspects of how care is delivered, and clearly reflect all aspects of individual needs. Management were working on this at the time of the inspection. Where individual preferences and interests are recorded in care plans, staff should be familiar with these. The service could do more to provide more individual activities and cater for a wider variety of interests throughout the day, to provide more stimulation for all residents. Key inspection report Care homes for older people Name: Address: The Willows 38 Westminster Road Earlsdon Coventry West Midlands CV1 3GB     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: Martin Brown     Date: 0 7 0 1 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: The Willows 38 Westminster Road Earlsdon Coventry West Midlands CV1 3GB 02476220161 02476550126 www.@adeptgroup.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Willows Care Home Ltd care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 32 The registered person may provide the following category of service only: Care Home Only (Code PC); 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) 32 Date of last inspection Brief description of the care home The Willows is a residential home for thirty-two older people. The home is located in the Earlsdon area of Coventry, close to the city centre, and near to amenities such as shops, places of worship and public transport. The home is located on three floors, with the upper floors accessed by a passenger lift. The accommodation consists of thirty-two single bedrooms, six of which have en-suite facilities. There are also two lounges on the ground floor, eight toilets, two assisted bathrooms, two assisted shower rooms, kitchen, conservatory/ dining area and administration office. There is also a basement, which is used as a staff room and for Care Homes for Older People Page 4 of 27 Over 65 32 0 2 5 0 2 2 0 0 9 Brief description of the care home storage. The home has gardens to the rear of the establishment and also has around six car parking spaces for visitors. Fees are detailed in the Service User Guide for the home and at the time of the inspection the manager advised ranged from £385.50 to £430.00 per person per week. This does not include extras such as hairdressing and private chiropody. Care Homes for Older People Page 5 of 27 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: This report has been made using information that has been gathered by the Care Quality Commission. The inspection visit was unannounced and took place on January 7th 2010, between 10.15am and 5.15pm. A tour of the premises was made, relevant documentation was looked at and the care of three people living at the home was looked at in detail. Interactions between staff and residents were observed during the inspection, and a dozen residents were spoken with regarding aspects of their care. Staff and management were spoken with, as well as four visiting relatives and a visiting professional. The self assessment form (AQAA), completed and returned earlier by the manager, also informed the inspection. People living at the home were able to offer varying and often extensive views on the care and support they received, and these, along with generally very positive views from relatives, helped to evidence the quality of the care they were receiving. Care Homes for Older People Page 6 of 27 Staff, management and residents were welcoming and helpful throughout. Care Homes for Older People Page 7 of 27 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 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 8 of 27 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 9 of 27 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. The home ensures that people are assessed prior to their admission, so that it can be confident it can meet their needs. People receive information about the home to help them make their choice. Evidence: We looked at how two people who were recently admitted came to the home, and their assessments. One person said they were very pleased with the home, and compared it very favourably to the care and support they had been receiving in hospital, prior to moving to the Willows. Among this persons comments were You get far more attention here than in hospital, the food is good - Im putting on weight. Initial care assessments informed developing care plans. Nutritional viability and nutritional screening were in evidence, and risk assessments to cover specific risks were in place. This person said they had come to the home for an initial three week stay, but were happy to stay longer. Care Homes for Older People Page 10 of 27 Evidence: A relative of another recent admission was spoken with. They too were admitted from hospital, and the relative felt that the care was 100 per cent better than in hospital. They were happy to have chosen this home, being impressed by its homeliness, believing some of the newer, more spacious and modern buildings to be rather clinical. This person felt that the staff and management had been very helpful in the initial move and difficult settling in period. Again, the stay involved an initial settling in period, but already it was noted that she was very happy here, which was confirmed by the resident, after an initial period of wishing to return home. Service User Guides and brochures give information about the home, but those spoken with about choosing The Willows said that they relied primarily on first hand experience of it. The previous inspection had noted that the home had admitted people without fully assessing their needs and subsequently found some needs difficult to meet. Assessments now enabled the home and prospective residents to be confident that their needs would be met. Residents are not primarily admitted for respite care. Where temporary placements are in existence, it tends to be where, as with the two people whose assessment and admission was looked at here, a temporary placement is offered, with the possibility of it becoming permanent. Care Homes for Older People Page 11 of 27 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. Residents can be confident that their health and personal care needs are met in ways that they are comfortable with, by a team that is familiar with those needs and knowledgeable on how to meet them, guided and supported by care plans. Required medication is delivered and recorded competently, and privacy and dignity is respected. Evidence: The care and support of three people were looked at in detail. These all had care plans detailing their needs and how these are to be met. These were clear and easy to follow, and detailed key areas such as mobility, nutrition, specific risks and their management, and were regularly reviewed. Care plans were in the process of being reviewed, with more detail being added in some instances. This had been noted as a shortfall, in that it was not sometimes explicitly clear exactly how particular residents should be assisted in particular aspects of care, such as washing. Staff spoken with were clear on individual care needs and how to meet them, and observation of interactions showed care and support being undertaken in a way that Care Homes for Older People Page 12 of 27 Evidence: suggested that staff were aware of the need to support in a way that individuals needed/wished. For example, one staff, adding gravy to a meal for a resident, was careful to check exactly where on the food the gravy was wanted. This proper level of attention was also noted in the way people were supported with mobility and transfers. One care plan, later looked at, did not appear to fully reflect the challenges presented by one person, who called out quite frequently and in a manner not clearly indicated in the care plan. Nevertheless, staff spoken with were clear and consistent on how to manage this behaviour. One care plan detailed one persons likes and dislikes, but a staff member spoken to did not appear very aware of this persons sporting and other likes, as expressed in the care plan. In more health orientated and support areas, staff were clear on needs and how to help meet them. Bruises were recorded in daily records, but management agreed that the use of body charts by staff would make these easier to note. They planned to introduce these, having, they said, previously been advised not to by other professionals. All residents appeared well groomed and cared for. All residents spoken with, save one, were complimentary about the staff and the care provided. One person felt that the care was generally good, but that one or two staff, used on an agency basis, did not always show the same commitment and positive attitude as others. This was brought to the attention of management. This person was also not happy that the morning paper was an hour or so late, having little sympathy with those delivering in icy conditions. Another person spoken to at length was very complimentary about the care, saying it was a home from home This person, who needed a lot of staff support, said I can have a bath whenever i like - I love a long soak. I see the doctor when I need to, and the hairdresser and the chiropodist. Another resident noted that the staff were very attentive, and came promptly when the call bell was pulled. This person also noted happily that she was putting on weight, and that things couldnt be better. Relatives spoken with were very complimentary about the care. No problems in five years was one comment, as was always been happy here. Care Homes for Older People Page 13 of 27 Evidence: One relative noted that there were staff of either gender, which helped particular preferences: My father is a private person, and prefers to be bathed by male staff which they are able to do. There was evidence of the involvement of health professionals in helping people maintain good health, with records of GP chiropody and dental visits. Staff spoken with were knowledgeable on individual health needs such as, for example, diabetes. Controlled medication was stored and recorded appropriately. All medication was stored securely. Recording of medication tallied with amounts remaining, showing that it was dispensed and recorded accurately. Clear details of the effects of individual medications was recorded, and it was re-assuring to see that where, for example, certain medications conflict with grapefruit juice, this was clearly noted. The one discrepancy noted was where one medication was refused. It took a phone call from the manager to the person who administered it to confirm that the refusal had resulted in the immediate destruction of this medication, rather than its return to the pharmacy. The manager agreed that this should be clearly recorded on the medication sheet to avoid any uncertainty over any whereabouts of this tablet. In some instances, counting and checking of non blistered medication was made less straightforward by staff having used tablets from different strips, rather in a more methodical manner. The medication cabinet where medication to be returned to the pharmacy was stored was rather crowded. Staff advised that this was exceptional, and caused by a large amount of medication to be returned, in combination with the Christmas break and inclement weather. Staff were seen to be respect individual privacy and dignity, knocking on doors, informing people when supporting them in weight transfers and ensuring they were aware of and comfortable with support. Care Homes for Older People Page 14 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the Willows have the opportunity to enjoy a variety of organised activities, but individuals may benefit from more time spent with them by staff on more individual, small-scale activities more personally tailored to their needs and wishes. Visitors are made welcome, and residents enjoy and appreciate the food provided. Evidence: There were not many activities, other than that of maintenance men, noted in the home during the inspection. This may have been a combination of the inclement weather and there being a relative lull after Christmas. There had been a variety of activities over the Christmas period, as noted in the activities record, in discussion with residents, relatives, and staff. The manager advised that they will display photos of Christmas activities, once they had cleared photos with individual residents, some of whom, the manager advised, were particular about what photos of then were displayed. There had been parties, entertainers and a raffle prior to Christmas. One relative noted that the activities programme seems quite full but wondered if all the scheduled activities took place, and felt that activities did not necessarily reflect what particular people wanted. There are two lounges, and sitting space round the Care Homes for Older People Page 15 of 27 Evidence: corner of the dining room. Televisions were on in both lounges, although no-one appeared to be watching them. After one was switched off before dinner, a resident turned it back on again immediately upon their return to the lounge after dinner, although, again, neither they, nor anyone else, appeared to be watching it. Residents in the lounge spent much of their time asleep. Medication did not appear to be the cause of this for individuals who were checked. Discussions were had with staff and management about whether more stimulation throughout the day might help residents be more alert. One member of staff said that the men liked to watch sport and one television would feature this when sport was on, usually in the evening. Some care plans noted that individuals enjoyed music of various types, but no music was played in the communal areas during the inspection. Some staff spoken with aware of specific individuals who particularly enjoyed music, but other than entertainers coming in occasionally, there seemed no arrangements to cater for this. In the afternoon, a member of staff used a large soft ball available to throw with residents in one lounge, which provided a stimulus for some. During this time, several otherwise quiet sleepy residents became quite animated. One resident spoken with said they preferred to stay in their room, as people in the lounge did not talk to them. When asked if there was an activities organiser, management said that they felt the funds that would be used for this role were better spent on ensuring staff had time to do activities. Staff observed during the inspection spent most of their time on direct care and support. Most residents spoken with concerning activities said that they were satisfied with the level of activities, and talked of activities that had taken place before Christmas. Two people spoken with, however, said there was not enough to do. One felt that, having been busy running a house most of her life, she suddenly found there was little to do, and that the occasional activity did not really fill the time. One person spoke of people visiting from the local church just to talk to people on a social basis, and appreciated this contact with the wider community. Several relatives of people living at the home visited during the inspection. All were complimentary about the service. Typical comments from relatives included We are always made welcome, and staff are always very friendly and approachable. All residents spoken with were very complimentary about the food. Lovely meals, I Care Homes for Older People Page 16 of 27 Evidence: can have what I like for breakfast and the food is always very good were typical comments. A meal was taken with the residents. This was nutritious and freshly prepared, although the cook apologised for having to depart from the menu in view of the poor weather affecting supplies available. The kitchen had been awarded top marks on the previous Environmental Health inspection. Care Homes for Older People Page 17 of 27 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. Residents can be confident that any complaints will be listened to, and that they are protected against the risk of abuse or neglect, by policies, procedures, and the ethos of the home. Evidence: The manager advised that there had been no complaints since the last inspection, and complaints in the complaints log dated back to this time. There had been one safeguarding issue in April which had been resolved. There was a suggestions box in the home and details of the complaints policy were available, as well as details of how to complain. We have received no complaints about this service since the last inspection, and no safeguarding referrals since April. Residents and relatives spoken with said they had no major complaints, but were confident of being heard if they did have concerns. The manager offers regular surgeries for relatives who may have concerns. Relatives and residents all said that the manager was very approachable. Staff spoken with were aware of safeguarding issues, and of what to do if abuse or neglect was witnessed, suspected, or reported. Care Homes for Older People Page 18 of 27 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 living at The Willows benefit from a pleasantly decorated and well-maintained environment that is clean, tidy, and homely. Evidence: The home is a conversion of two older houses. It is well decorated and furnished, and was clean and tidy on the day of the inspection. As an older property it suffers from relatively narrow corridors, is accessible on its three floors by a lift, or relatively steep stairs for staff use. One relative commented that it is homely and, in their view, far more preferable to other purpose built establishments looked at which, although arguably more suitable, were too clinical. Homely was a word used by several residents and relatives. The home was uncluttered - equipment to support peoples mobility was in evidence, but was not obtrusive. Individual rooms are made homely according to the wishes of the person in them, with photos and personal items much in evidence. It was a very cold day, and maintenance workers were busy trying to fix radiators which were not working very effectively in the dining room. This meant the dining room was rather cold, with temporary heaters in place to provide extra heat. Other communal areas, and bedrooms, were sufficiently warm. One resident, sitting in the dining room after dinner, complained of being cold, but did not wish to move, and was Care Homes for Older People Page 19 of 27 Evidence: content with a blanket. Communal and other areas had sufficient lighting, and toilets and bathrooms were clean and tidy. There is an accessible garden area, but this was covered in snow. The home was generally fresh and airy and clear from unpleasant odours, other than a slight odour in one room, which management were aware of, and were actively seeking to eliminate. The laundry is small and was tidy. Staff explained procedures for ensuring the risk of cross infection is kept to a minimum. The home had notified us of an outbreak of sickness and diarrhoea, but advised that this had been successfully contained. There were no adverse comments about the laundry, other than one person noting that things sometime get mislaid and a relative noted that some items had got lost a few years ago, but theyd had no problems since then. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at The Willows appreciate the attentions of a staff team who are able to meet their personal care needs in ways that respect their dignity and privacy and promotes their well-being. More staff would enable more individual activities to take place in accord with individual needs and preferences. Evidence: Throughout the inspection staff were busy meeting peoples care and support needs. Call bells were answered promptly, and people were helped and supported in calm, patient and positive ways that respected their dignity and privacy. Kitchen, maintenance and domestic staff were in evidence, leaving care staff free to concentrate fully on care tasks. There were sufficient staff on duty to meet care and support needs, but there was little time apart from this for staff to be able to spend time with residents on personalised activities. Some agency staff are used, on night shifts. The manager advised that the staff team is now more settled and new staff have enabled the rota to be filled by permanent staff. Several of the staff spoken with were relatively recent recruits. One was still undertaking induction. Residents were almost unanimous in their praise of the staff, with only one critical comment, by one resident, directed towards an agency staff. The staff are wonderful - nothing is too much trouble was a typical comment. Care Homes for Older People Page 21 of 27 Evidence: A sample of staff files were looked at. These showed recruitment was done properly to help safeguard vulnerable people, with appropriate checks taking place and suitable references being obtained. A clear training matrix was available, which showed the majority of training up-todate, with plans in place to make good any shortfalls, where refresher training for some staff had not taken place within recommended times. This was the case for four staff with regard to manual handling, for whom training had been booked in for the following month. Management advised that the majority of staff had completed the National vocational Qualification in Care level 2, with a number doing or having achieved level 3. An NVQ assessor visited one person regarding this during the inspection, and one staff spoke of their keenness for achieving this qualification. Care Homes for Older People Page 22 of 27 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 living at The Willows can be confident that the home is well-run, that their views are being taken into account, and that their well-being and safety is protected. Evidence: Since the last inspection, when the home achieved an adequate rating, the manager has left, to be replaced by one who, staff and current management felt, made necessary improvements before moving on. The home is currently managed by an acting manager who has worked at the home for many years, principally as a deputy manager. She advised that she is now applying to register as manager. Residents were full of praise for her, particular her availability and accessibility: (She) comes in to see me every day - a lovely lady - no airs and graces. The manager is supported by the organisations operations manager, who was present on the day of this inspection. Care Homes for Older People Page 23 of 27 Evidence: A maintenance man was present, ensuring entrance paths were clear and safe in the cold weather. Workmen were notable in the house, fixing radiators and mending window seals. Other than these radiators, which were being attended to, no other shortfalls or safety issues were noted during the inspection. The Annual Quality Assurance Assessment completed and returned by the management, advised that all safety checks take place within a timely manner. The service has conducted surveys of residents, getting satisfaction ratings of areas such as food and activities. These were sampled. Responses showed a high satisfaction with food and meals, and a mixed, though generally positive, response to questions about activities. The manager advised that these results had yet to be collated so that responses and future plans based on them could be made. The manager also gave details of residents meetings, and regular relatives surgeries, whereby relatives can see the manager about any issues that may be concerning them. The person responsible for finances was spoken with about residents personal monies. They advised that the home does not keep any personal monies of residents, and that any expenditure paid for by the home (for example, hairdressing costs) is billed to relatives to repay later. One person currently without a relative to do this has an Age Concern advocate. Care Homes for Older People Page 24 of 27 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 25 of 27 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 In order to better ensure person centred care, all staff should be familiar with individual preferences and interests as detailed in care plans, especially where individual residents have difficulty articulating these. The use of body map charts may be helpful in recording any bruises, skin and pressure area concerns. The outcome of any refused medication, where the refusal has effectively resulted in the destruction of that medication, should be clearly noted in the relevant medication record. Residents may benefit from more individually tailored activities specifically related to their preferences and interests. More staff, or the employment of an activities organiser, would enable staff to spend more time with residents to give them individual attention and support individual activities. 2 3 7 10 4 12 5 27 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!