Care Home: The Willows Intermediate Care Service

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What the care home does well The staff have developed good information which is given to people prior to their stay. A copy is available in all the bedrooms, and in a number of different formats and languages if required. People have their needs assessed in detail and a plan of care is agreed with the person, which describes the care and support offered to them. Care plans are added to, by the many professionals within the home. Both assessments and care records are frequently up-dated to ensure they reflect the changing care needs of people living in the home. This ensures people have the correct amount of assistance, to help them regain lost skills and assists them back into the community. Staff have a good understanding of the risks relating to people and have put risk assessments in place to reduce risks associated with each person. People have good access to healthcare services to meet their personal and healthcare needs. Staff administer medication safely to people, staff follow a set process to ensure they are not distracted. Service Users have individual programmes geared to their independence, self care and socialising. Service Users undertake a range of activities assisted by staff, and have a range of choices making their stay a positive experience. The menu reflects peoples individual needs and choices, and staff are aware of peoples dietary needs, likes and dislikes. We looked at the training staff have undertaken before working with service users. This told us that staff have a good range of skills to help people in the home, that is then added to periodically. The staff monitor the quality of care, facilities and safety within the home. A detailed survey was undertaken recently with questionnaires being sent out to a number of people with interests in home. The policies and procedures provide good guidance for the staff to operate safe working practices. Comments from the surveys forwarded to service users and their relatives prior to the visit, and those made on the day include. What the home does well. "Rehab assistants very caring and attentive. On the whole an excellent facility which could be even better with a few additions to procedure and more rehab staff". "The care in the home is very good, X is well looked after". "Try to maintain independence, dignity and respect". "Staff work very hard, always willing to chat, nothing too much trouble". "Accommodation clean and cheerful, food good". "They create a home from home, lots of interaction with residents and staff, and lots of activities". From the surveys forwarded to staff the following comments were made. What the home does well. "Assessments for activities of daily living". "Comprehensive service (Occupational Therapists and Physiotherapists). Very good rehabilitation staff and a good reputation". "Try our best to meet the needs and requirements of individual Service Users". "Care well for the Service Users we look after". "Care for Service Users and offer choice". "Meet the cultural, emotional and social needs of the people who use this service". What has improved since the last inspection? A number of areas were highlighted by the manager in the AQAA document, these include; Half of people accessing the service have gone home. This is a good outcome as most of the people coming in the Willows have been identified as needing long term care. Our approach to providing care people with memory loss and dementia has improved. The service has changed to also offer a mental health service which involved training and re-skilling around working styles and practices. The appointment of clinical mental health specialist has helped us to consider peoples needs in relation to their memory loss and dementia in a more informed manner. We have approached dementia care in a creative manner seeking to find individuals solution to peoples needs involving them and meaningful people in their lives. We are using Telecare within the unit to help detect individual movement at night so assist to re-orientate people can be done in the most sensitive and unobtrusive manner. We have purchased activity materials for service users so care staff have resources they need. Staff are spending time concentrating on one to one activities especially when these help a person to manage living with memory loss and dementia. Life history work being completed in the next 12 months with service users. Weekends now concentrate on social and recreational activities. We have continued to improve all communal areas, bedrooms and carpets as required. We have new individual controlled heating installed in all bedrooms and a new boiler and heating system fitted to reduce our carbon impact. What the care home could do better: Staff could restrict medication ordering to one book at a time, this would clarify the process, and make it easier to track orders and changes. Staff could date any complaints or compliments received, this would then be a guide when completing paperwork on these statistics. Staff could record all complaints in the same paperwork. This would ensure all complaints were dealt with in the same way. When displaying Quality Assurance comments, staff could note how and when these were followed up. Comments from the surveys forwarded to service users and their relatives prior to the visit, and those made on the day include. What the home could do better. "Seems a lack of communication between OT`s, Physios, mental health professionals and family members. Little account of what rehab assistants opinions when decisions re service users future accommodation being made". "Short stay home, everything seems to be taken care of". Of the returned surveys one relative stated they were unsure how to log a formal complaint. From the surveys forwarded to staff the following comments were made. What the home could do better. "General communication between staff and clinicians; and involvement with the home visit". "Feel the communication between social teams, clinicians and service user families need to be improved". "Nothing we already give a good service". "Have more staff to cover (annual) leave and sickness". Key inspection report Care homes for older people Name: Address: The Willows Intermediate Care Service Ambergate Road Beechdale Estate Nottingham NG8 3GD     The quality rating for this care home is:   three star excellent 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: Keith Williamson     Date: 1 2 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 Intermediate Care Service Ambergate Road Beechdale Estate Nottingham NG8 3GD 01159153142 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.nottinghamshire.gov.uk Nottingham City Council care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Nottingham City Council is registered to provide accommodation and personal care at The Willows Intermediate Care Service for male and female service users whose primary care needs fall within the following categories: Old age not falling within any other category (OP) over 50 years of age. Dementia, over 65 years (DE(E)). Dementia, over 50 years(DE). The maximum number of persons to be accommodated in The Willows Intermediate Care Service is 16. Date of last inspection Brief description of the care home The Willows Resource Centre is a multifunctional complex situated in a residential area that has a high proportion of elderly residents. The complex is very close to a range of community facilities including a church, shops and a community centre. The complex offers a range of facilities to people aged fifty years and over. The Willows residential unit provides Intermediate care for up to sixteen people. It is Care Homes for Older People Page 4 of 27 Over 65 16 16 16 0 Brief description of the care home owned by Nottinghamshire City Council Social Services and is run in partnership with Nottingham Health Authority. The residential unit is a single storey building with sixteen single bedrooms, none of which meet the National Minimum Standards size requirements. All bedrooms are well decorated and comfortably furnished. None of the bedrooms have en-suite facilities but there are sufficient toilets and bathrooms, conveniently located throughout the building. There is an inner courtyard garden, which has been well maintained and is accessible by all residents. Nottingham City Council are considering converting some beds from Intermediate care into assessment beds - this would mean that residents would stay for a short term period, and be assessed as to whether they need residential care, or could return to their homes. Fees: The fees at the Willows are assessed on an individual basis, and differ according to circumstances. 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of the inspection is on outcomes for Service User and their views of the service provided. The main method of Inspection used was case tracking which involves selecting a sample number of people and tracking the care they received through talking with them where possible, and looking at their records and accommodation, in this case three Service Users were chosen. This visit took place over one day, commencing at 9.30am and took six hours to complete. An opportunity was taken to talk with Service Users, manager and staff, look around the home, view records, policies and care plans. Information was obtained from the Annual Quality Assurance Assessment(AQAA), which gives details about the home, and is filled in by the registered manager. A copy of the last Care Quality Commission (formerly the CSCI Commission For Social Care Inspection) report is displayed at the homes office, and copies of this report are available from the registered manager. Care Homes for Older People Page 6 of 27 Surveys were sent to Service Users, their relatives and staff comments made by them, and those made on the day have been included in this report. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. Care Homes for Older People Page 7 of 27 What the care home does well: The staff have developed good information which is given to people prior to their stay. A copy is available in all the bedrooms, and in a number of different formats and languages if required. People have their needs assessed in detail and a plan of care is agreed with the person, which describes the care and support offered to them. Care plans are added to, by the many professionals within the home. Both assessments and care records are frequently up-dated to ensure they reflect the changing care needs of people living in the home. This ensures people have the correct amount of assistance, to help them regain lost skills and assists them back into the community. Staff have a good understanding of the risks relating to people and have put risk assessments in place to reduce risks associated with each person. People have good access to healthcare services to meet their personal and healthcare needs. Staff administer medication safely to people, staff follow a set process to ensure they are not distracted. Service Users have individual programmes geared to their independence, self care and socialising. Service Users undertake a range of activities assisted by staff, and have a range of choices making their stay a positive experience. The menu reflects peoples individual needs and choices, and staff are aware of peoples dietary needs, likes and dislikes. We looked at the training staff have undertaken before working with service users. This told us that staff have a good range of skills to help people in the home, that is then added to periodically. The staff monitor the quality of care, facilities and safety within the home. A detailed survey was undertaken recently with questionnaires being sent out to a number of people with interests in home. The policies and procedures provide good guidance for the staff to operate safe working practices. Comments from the surveys forwarded to service users and their relatives prior to the visit, and those made on the day include. What the home does well. Rehab assistants very caring and attentive. On the whole an excellent facility which could be even better with a few additions to procedure and more rehab staff. The care in the home is very good, X is well looked after. Try to maintain independence, dignity and respect. Staff work very hard, always willing to chat, nothing too much trouble. Accommodation clean and cheerful, food good. They create a home from home, lots of interaction with residents and staff, and lots of activities. From the surveys forwarded to staff the following comments were made. What the home does well. Assessments for activities of daily living. Comprehensive service (Occupational Therapists and Physiotherapists). Very good rehabilitation staff and a good reputation. Try our best to meet the needs and requirements of individual Service Users. Care well for the Service Users we look after. Care for Service Users and offer choice. Meet the cultural, emotional and social needs of the people who use this service. Care Homes for Older People Page 8 of 27 What has improved since the last inspection? What they could do better: Staff could restrict medication ordering to one book at a time, this would clarify the process, and make it easier to track orders and changes. Staff could date any complaints or compliments received, this would then be a guide when completing paperwork on these statistics. Staff could record all complaints in the same paperwork. This would ensure all complaints were dealt with in the same way. When displaying Quality Assurance comments, staff could note how and when these were followed up. Comments from the surveys forwarded to service users and their relatives prior to the visit, and those made on the day include. What the home could do better. Seems a lack of communication between OTs, Care Homes for Older People Page 9 of 27 Physios, mental health professionals and family members. Little account of what rehab assistants opinions when decisions re service users future accommodation being made. Short stay home, everything seems to be taken care of. Of the returned surveys one relative stated they were unsure how to log a formal complaint. From the surveys forwarded to staff the following comments were made. What the home could do better. General communication between staff and clinicians; and involvement with the home visit. Feel the communication between social teams, clinicians and service user families need to be improved. Nothing we already give a good service. Have more staff to cover (annual) leave and sickness. 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 10 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 11 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. Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective Service Users. Evidence: The staff have developed a comprehensive statement of purpose and service users guide, which is tailored to the current group of people in the home. The information which also includes the complaints procedure is available in all the bedrooms, and in a number of different formats if required. This ensures everyone in the home can understand it. People have their needs assessed in detail prior to moving into the home. The assessments seen were very detailed and included continually updated information, recognising any changes in the persons abilities and needs. The process is clearly directed to suit the individual, with clear goals toward moving on, and back home. Care Homes for Older People Page 12 of 27 Evidence: Comments from the surveys forwarded to staff prior to the visit, and those made on the day include. What the home does well. Assessments for activities of daily living. Care Homes for Older People Page 13 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 excellent 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, health and medication needs met appropriately. Evidence: We looked at the care records of people. We found them to be very detailed and descriptive of the care and support offered to people. Care plans are formed from the detailed assessment, and are added to by the many professionals within the home. We saw that care records were frequently up-dated to ensure they reflected the changing care needs of people living in the home. This ensures people have the correct amount of assistance, to help them regain lost skills and back into the community, and exceeds the minimum standard. We saw that staff have a good understanding of the risks relating to each person who lives there, and have put risk assessments in place to reduce risks associated with each person. We looked at the personal and healthcare records of people. We saw that they have good access to healthcare services to meet their personal and healthcare needs. On Care Homes for Older People Page 14 of 27 Evidence: talking to staff as well as looking at the records, we found that staff act quickly on concerns they have about peoples needs, and these prompt actions have resulted in a good quality of life for those concerned. We looked at the way staff give out medication and found that staff are administering medication safely to people. The policy and procedures followed by the staff are very comprehensive. These tell us that the staff giving out medicine have a process to follow, part of which ensures they do not answer the phone and so are not distracted from the task in hand. We saw staff records and these showed us that staff have undertaken training in the administration of medication. Comments from the surveys forwarded to service users and their relatives prior to the visit, and those made on the day include. What the home does well. Rehab assistants very caring and attentive. On the whole an excellent facility which could be even better with a few additions to procedure and more rehab staff. The care in the home is very good, X is well looked after. Try to maintain independence, dignity and respect. Staff work very hard, always willing to chat, nothing too much trouble. What the home could do better. Seems a lack of communication between OTs, Physios, mental health professionals and family members. Little account of what rehab assistants opinions when decisions re service users future accommodation being made. Short stay home, everything seems to be taken care of. From the surveys forwarded to staff the following comments were made. What the home does well. Comprehensive service (Occupational Therapists and Physiotherapists). Very good rehabilitation staff and a good reputation. Try our best to meet the needs and requirements of individual Service Users. Care well for the Service Users we look after. Care for Service Users and offer choice. What the home could do better. General communication between staff and clinicians; and involvement with the home visit. Feel the communication between social teams, clinicians and service user families need to be improved. Nothing we already give a good service. Care Homes for Older People Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are fully committed in supporting individuals to lead purposeful and fulfilling lives as independently as possible. Evidence: We looked at the social care plans of Service Users. Service Users have individual programmes geared to their independence, self care and socialising. An activities organiser has been recently employed to assist in this process. Service Users undertake a range of activities assisted by staff, both at the home and in the local area. Again these are tailor made for people to assist them in regaining personal skills, and enable their return home. Staff are aware of the preferences of people in terms of where they prefer to sit in the home, and when they like to have company or be alone. We saw staff talk to and interact well with people who live there. Staff are also aware of peoples dietary needs, likes and dislikes. We saw the menu for people, this reflected peoples individual needs and choices. Care Homes for Older People Page 16 of 27 Evidence: Comments from the surveys forwarded to service users and their relatives prior to the visit, and those made on the day include. What the home does well. Accommodation clean and cheerful, food good. They create a home from home, lots of interaction with residents and staff, and lots of activities. Comments from the surveys forwarded to staff prior to the visit, and those made on the day include. What the home does well. Meet the cultural, emotional and social needs of the people who use this service. 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. Service Users and others involved with the service say that they are happy with the service provided, feel safe and well supported by an organisation that has their protection and safety as a priority. Evidence: We looked at the complaints procedure and saw that this was written in a way which is helpful for people living at the home to understand. We saw very good interaction between people who live in the home, and staff who support them. We were told in the AQAA that the views of people living in the home are important, and that the service wants to get it right first time. We saw by looking at staff training records and by talking to them that staff have a good understanding of safeguarding policies and procedures. Staff know what to do if they suspect that a person who lives in the home is being abused in any way. People who live in the home have their own bank accounts. Staff support some people in being responsible for their money. We checked the financial records at the home, and found accurate recording of money balances. This includes a very secure tagging system for each individual persons money. Comments from the surveys forwarded to service users and their relatives prior to the visit, and those made on the day include. What the home could do better. Of the Care Homes for Older People Page 18 of 27 Evidence: returned surveys one relative stated they were unsure how to log a formal complaint. Care Homes for Older People Page 19 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 live in a purpose built, safe and secure environment. Evidence: We looked at the communal areas of the home and the bedrooms of people who live there. We found the communal areas to be very well decorated and homely. The bedrooms were individually constructed to the needs and preferences of the people using them. Other parts of the home have been adapted with special toilets and hoists to assist with peoples mobility. The staff have a detailed maintenance and renewal programme for furniture and fittings in the home. This is continually updated, as part of the quality control in the home and we saw how that led to the home being well maintained. Staff are aware of hygiene and how to control the spread of infection. This is important as it keeps people safe in the home. 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 are supported and protected by the homes recruitment practices and number of staff on duty. Evidence: We saw good interaction between staff and people who live in the home, and staff demonstrated a very good understanding of the needs of people living there. People have regular support from a variety of social and health care staff throughout the day. This is based on peoples individual goals and directly linked to their plan of care. All staff said they were supported well to do their job, through induction training, on going training and regular supervision. We looked at a sample of staff recruitment records, and saw that all the necessary checks were made to safeguard people who live at the home. We looked at training records and this confirmed that staff have undertaken a wide range of training to help them in their roles, some of this before working with service users. Training included health and safety, medication management. Training is organised from in house as well as external sources, and staff have written tests following some of the courses. This indicates senior staff monitor how well staff perform within the home, and arrange further training accordingly. Care Homes for Older People Page 21 of 27 Evidence: Comments from the surveys forwarded to service users and their relatives prior to the visit, and those made on the day include. What the home could do better. Have more staff to cover (annual) leave and sickness. 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 live in a home that is safe and well managed. Evidence: The current manager has recently transferred to the home and is in the process of applying to be the registered manager. There are many levels of Quality Assurance(QA) and monitoring systems in place to ensure peoples satisfaction with, and safety within the home. A detailed survey was undertaken recently with questionnaires being sent out to a number of stakeholders, as well as the Service User group at the time. Other forms of QA include feedback from relatives, regular staff checks on the building and visits from senior managers. Outcomes from the QA monitoring is made available to people in the home, their representatives and those considering coming to stay at the home, with additional comments being posted in the reception area. We viewed a number of the policies and procedures. We were satisfied that these Care Homes for Older People Page 23 of 27 Evidence: provide good guidance for the staff to operate safe working practices. We looked at a number of tests the staff do to monitor areas such as the fire detection system, the hot water regulating system, and other areas such as electrical testing. These were up to date and showed us the staff monitoring helps keep people safe in the home. 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 9 Staff could restrict medication ordering to one book at a time, this would clarify the process, and make it easier to track orders and changes. Staff could date any complaints or compliments received, this would then be a guide when completing paperwork on these statistics. Staff could record all complaints in the same paperwork. This would ensure all complaints were dealt with in the same way. When displaying Quality Assurance comments, staff could note how and when these were followed up. This would ensure transparency, and assure people of issues being followed up on an individual basis. 2 16 3 16 4 33 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. 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