Care Home: Threshfield Court

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What the care home does well The home is managed in a manner that puts the people who live there first. It concentrates on their needs, wishes and views. People are provided with enough information and given the opportunity to have a trial stay at the home before they move in permanently. This helps them decide if Threshfield Court is the right place for them to live. The staff are aware of the major life change that moving into the home is for people and are given extra support to help them settle into the home. Threshfield Court provides specialist care for people with dementia related illness. The home has been awarded the Independent Health Care Award for Innovation in Dementia Care. This shows the home promotes good practice and this will result in a better quality of life for people with dementia. All the staff in the home receive training about how to help people with dementia, this means they are all confident in meeting, greeting and talking with people in a friendly and positive way. People are encouraged to be independent and make choices about how they want to live their lives. Staff at the home provide specialist care promoting people`s self esteem and support individuality. Relatives tell us that they feel people are supported to make their own choices. "The home treats residents as individuals, respects their wishes and their likes and dislikes" "This is a warm and friendly home, staff go out of their way to help you" There are various outings arranged and in house activities, which allow people contact with the local community and provide stimulation. Visitors are encouraged and made welcome. People tell us, " The staff are very friendly, it is like being in your own home and there is always lots to do" The home has a warm friendly atmosphere, with good staffing levels and a well trained and supported staff team. The staff work hard to make people comfortable and are proud of the care they provide. The staff tell us, " We try to get to know people really well and help them to do things they really enjoy" "This is a good home to work for they really care about the people who live here" The environment is comfortable, well maintained and consistently clean and fresh. The home is well run and the Manager along with Barchester Health care Ltd continually seek the views of people and staff to provide the best care they can. What has improved since the last inspection? The medication storage and administration has improved. The home had completed care plans and continued to make sure they are reviewed when people`s needs are changing. The home continues to ensure a high quality of environment. What the care home could do better: The service is open and constantly self reflective and amends practice where the need requires. Key inspection report Care homes for older people Name: Address: Threshfield Court Station Road Threshfield Skipton North Yorkshire BD23 5ET     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: Linda Trenouth     Date: 2 5 0 6 2 0 0 9 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) 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 29 Information about the care home Name of care home: Address: Threshfield Court Station Road Threshfield Skipton North Yorkshire BD23 5ET 01756752200 01756752666 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.barchester.com Barchester Healthcare Homes Ltd care home 61 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 61 The registered person may provide the following category of service only: Care Home with Nursing - Code N, To service users of the following gender: Either, Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places 30, Dementia - Code DE, maximum number of places 31, Physical Disability - Code PD, maximum number of places 5 Date of last inspection Brief description of the care home Threshfield Court offers nursing and personal care for up to sixty-one people with general nursing needs, physical disabilities, dementia, and mental disorder. The home is situated in the small village of Threshfield close to Grassington in the Care Homes for Older People Page 4 of 29 31 0 5 Over 65 0 30 0 Brief description of the care home Yorkshire Dales. The nearest town is Skipton. The home is a large detached building with accommodation on three floors, and a passenger lift to all the floors. Most of the bedrooms are en-suite. The home has large attractive well-maintained gardens and car parking. The weekly fees range from £500 to £800. This does not include costs for items such as Hairdressing or Chiropody. 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: 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: There were several ways we gathered information to make this report. We used information about the home kept by the Care Quality Commission and asked for up to date information from the home via an AQAA, which is a pre inspection questionnaire. We also sent out questionnaires to people who live at the home and staff to gain their views. We made a visit to the home, this was announced and carried out by one inspector and lasted seven hours. We spoke to people who use the service, their relatives, and staff. We also looked at care records and other records held in the home. We walked around the home to see how safe and comfortable it was. Some time was also spent observing staff supporting people, with a particular focus on the Memory Lane Unit . Care Homes for Older People Page 6 of 29 We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as commendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 29 What the care home does well: The home is managed in a manner that puts the people who live there first. It concentrates on their needs, wishes and views. People are provided with enough information and given the opportunity to have a trial stay at the home before they move in permanently. This helps them decide if Threshfield Court is the right place for them to live. The staff are aware of the major life change that moving into the home is for people and are given extra support to help them settle into the home. Threshfield Court provides specialist care for people with dementia related illness. The home has been awarded the Independent Health Care Award for Innovation in Dementia Care. This shows the home promotes good practice and this will result in a better quality of life for people with dementia. All the staff in the home receive training about how to help people with dementia, this means they are all confident in meeting, greeting and talking with people in a friendly and positive way. People are encouraged to be independent and make choices about how they want to live their lives. Staff at the home provide specialist care promoting peoples self esteem and support individuality. Relatives tell us that they feel people are supported to make their own choices. The home treats residents as individuals, respects their wishes and their likes and dislikes This is a warm and friendly home, staff go out of their way to help you There are various outings arranged and in house activities, which allow people contact with the local community and provide stimulation. Visitors are encouraged and made welcome. People tell us, The staff are very friendly, it is like being in your own home and there is always lots to do The home has a warm friendly atmosphere, with good staffing levels and a well trained and supported staff team. The staff work hard to make people comfortable and are proud of the care they provide. The staff tell us, We try to get to know people really well and help them to do things they really enjoy This is a good home to work for they really care about the people who live here The environment is comfortable, well maintained and consistently clean and fresh. Care Homes for Older People Page 8 of 29 The home is well run and the Manager along with Barchester Health care Ltd continually seek the views of people and staff to provide the best care they can. 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 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with good information and their needs are identified and planned for before moving in, to make sure that the home is right for them. Evidence: People are given thorough information about the home and the care the service is able to provide. In addition to the brochure for the home a new booklet has been produced called choosing a dementia care home. This helps people who are experiencing dementia decide if the home is right for them. People are invited to visit the home and are also encouraged to have a trial stay to decide if the home is right for them. One individual had recently been admitted to the home and their records were reviewed. The manager had undertaken a full assessment prior to them moving in to make sure the home would be able to meet their needs. The assessment was Care Homes for Older People Page 11 of 29 Evidence: comprehensive covering all aspects of Social and Health needs. The assessments also included individual preferences. This is important to make sure the home meets peoples needs in a way that they prefer. Relatives and people living at the home confirmed that they had been given information and visited the home before making a decision to move in. Staff said before people move in they are allocated a key worker who prepares the room, making sure it has been cleaned thoroughly, and the nurse call system and the TV remote are working. On the persons arrival they would help them unpack and check on them regularly, providing the time for them to ask questions about the home. Relatives tells us that people are treat as individuals and the home makes sure they are cared for in the way they prefer. The home treats them as individuals, respects their wishes and their likes and dislikes 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. People are treated with respect and dignity by the staff and they receive personal care based on their individual needs. Evidence: Relatives visiting the home said that the care at the home was always very good. They said that they visited every day and had many opportunities to observe the staff and the care that they give, they were very pleased and complimented the staff saying, The staff are very kind and patient with everyone, they work very hard to make people comfortable. One individual said that she was happy with the way in which she was cared for and felt that staff always treat her with respect. Staff were observed providing personal care in a kind, considerate way, respecting and promoting peoples privacy and dignity. Care Homes for Older People Page 13 of 29 Evidence: Relatives tell us, the home puts residents first whilst taking care of relatives and giving them support The staff give very good individual care to residents, nothing is to much trouble Staff clearly had very good knowledge about peoples preferences and the way in which they liked to be cared for. Staff approached individuals in a gentle and calm manner. Three care plans from the, Memory lane, unit were reviewed. This unit provides specialist care for people with dementia related illnesses. The care plans were good and were clearly person-centred, this means enabling each individual to make the most of his or her abilities in the way they prefer. The records covered personal hygiene, communication, mobility, mental health and cognition, breathing, sleeping, pain, religious and social interests, relationships, hopes and concerns for the future. The care plans also included, risk assessments in nutrition, tissue viability, mobility and falls. All identified health and personal care needs in detail. The information also showed how people were consulted in any decision making. The care records had been reviewed regularly, this is important to make sure that any changing needs are not overlooked. People living in the home were observed to be well cared for and dressed appropriately according to their preferences. The care records showed people were accessing Health Care Professionals, such as GPs, Chiropodists, Physiotherapists, Occupational Therapists, Dietitians and District Nurses. The Dentist is now visiting the home regularly. There is a clear medication procedure to guide the staff practice and training is provided on safe storage, administration and disposal of medicines. Medication was checked in the Memory Lane Unit, the medicines are stored responsibly and records kept up to date. Peoples individual choices, rights and liberties are protected. The home promotes involvement and support from Advocacy groups. This has included Craven Advocacy Care Homes for Older People Page 14 of 29 Evidence: and Mental Health Advocacy. 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. People live the way they choose with opportunities for innovative social, cultural and recreational experiences. Evidence: All the care records have information about peoples preferred, social activities and interests, and in the Memory Lane Unit, detailed life histories had been completed. This helps inform the staff and makes it easier for them to help people continue their hobbies and interests when they are living in the home. The home aims to create a positive atmosphere for people living at the home who are experiencing dementia. They have put into place innovative ideas which are focused on peoples individual ability and experiences. The home has also looked at who lives together and matched people with similar abilities. This has resulted in a more homely environment and more social interaction. The social therapy assistant role also continues to work well and ensures social activity is a priority. Some time was spent visiting the, Memory Lane area of the home. The staff have Care Homes for Older People Page 16 of 29 Evidence: introduced memory boxes that are created with the help of families and care staff. The care plans also included details of peoples past interests, hobbies and life experiences. This helps staff understand peoples histories and support them in a way that is meaningful. The corridors of the unit are imaginatively covered in photographs and memorabilia for people to look at with many displays that are tactile and created for people to interact with. During the day people on the Memory Lane unit were being encouraged to help with the daily living tasks such as washing up and setting the tables. Some enjoyed an afternoon sing song and sat with staff and enjoyed one of the visiting homes dogs, Ashleigh. Some individuals preferred to walk around Memory lane, which they are able to do unhindered. People appeared contented, staff were prompt to reassure people where needed. The care staff do not wear uniforms to help create a relaxed and informal atmosphere, which is very important in terms of comfort and reassurance. The manager explained that the staff also dine with people at meal times. This helps to make the meal more of an occasion and individuals feel more comfortable and relaxed. The care records and the newsletter showed there is a good range of activities for people to join in if they wish. People who live on the ground floor also experience a good range of activities, including art, card games, exercises, baking, karaoke, music and gardening. People tell us that outings are organised to local places of interest and lunch at local public houses. There is a booklet with news clippings about people and events at the home and a newsletter informing of any forthcoming events and achievements within the home. Staff were observed welcoming visitors into the home, special thought had been taken to enable people living in the home to feel comfortable when asking friends to visit and dine with them. To encourage visitors comfort and welcome the community the home has created a small are into a cafe with menus and appropriate table settings and cafe style chairs. There are three main meals per day and a choice is provided at each. Menus were Care Homes for Older People Page 17 of 29 Evidence: looked at and these were nutritious and varied. Special dietary needs are catered for and special requests can usually be met. People generally spoke positively about the quality of meals provided and people said they enjoyed their lunch. Relatives comments included, The meals are very good here and we are always offered hospitality when we visit, staff make us feel very welcome. Staff say, The meals are good and we sit and eat with residents at meal times and have a chat The Senior Nurse and Head Chef have won an award for Nutrition presented by the National Association of Care Catering. Differing religious and cultural needs are accommodated in the menu choices at the home. The home also celebrated a wide variety of different cultural festivals and encourages their staff to wear their traditional clothes. People have an opportunity to have their say through satisfaction surveys and residents meetings. The home has listened to peoples wishes and ideas and altered the environment to create smaller areas within the home for people to socialise in small groups. They have also made alterations to the garden to make it more accessible by changing an incline in the path and by creating a path through the woods. The manager promotes a positive relationship with local community including the primary and secondary schools. The secondary school places students on placement and the local primary school have been working on a project with the gardener. 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 can be confident that concerns are listened to and appropriate action is taken. Evidence: The complaints policy is in the brochure for the home and in the service user guide. The manager deals with general day-to-day complaints and anything more serious is passed to the organizations quality assurance manager to investigate. The manager has placed a comments book in the dining room to feedback to the catering staff any suggestions as well as any issues raised. The home records concerns so they can identify if there are any recurring issues and then uses this information to improve the service provided. Threshfield Court and the Care Quality Commission have received two complaints which has been responded to. Other agencies have also been involved to review these concerns. The Commission is now satisfied that the organisation has responded appropriately and, where required, amended practice. The home has a copy of the North Yorkshire County Council Safeguarding Adults procedure and staff confirmed that they have received training and showed a good Care Homes for Older People Page 19 of 29 Evidence: understanding about what they would do if they suspected abuse. 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 comfortable, clean and safe home. Evidence: The visit to the home was unannounced and the home was fresh, clean and well maintained. Visitors and people who live in the home confirmed that housekeeping was consistently good. The home is extensively decorated with homely items such as comfortable furniture, bookcases, pictures and ornaments. The home is on three floors, which are accessible by a passenger lift, the 1st and 2nd floors have been specially adapted for people with dementia. The home is organised in to smaller living groups. This is to promote peoples well being. The manager and staff have used the environment to imaginatively and positively promote their abilities. There are lots of things around the home that help to provide people with comfort and a feeling of well being for instance, soft toys, dolls, sensory fabric, cushions, throws and rugs. Care Homes for Older People Page 21 of 29 Evidence: There are well kept gardens, which have won various awards and are specially adapted for people with dementia. During the site visit, people said how much they enjoyed walking in the gardens and watching the wildlife. One gentleman said he had a daily walk around the wooded area to keep fit. The area called, Memory Lane, has been innovative decorated to a very high standard. The area has many displays on the walls, which are aimed at helping the person feel they are in comfortable and familiar surroundings. There are also tactile areas and themes linked to help people. There are pictorial signs for the bathrooms, toilets and bedrooms to help people find their way around. Bedroom and bathroom doors are easily recognisable through the use of positive ideas using pictures, colour and words. There is a joint lounge and dining room where people were engaged in daily living tasks and staff were able to help people make drinks and snacks. All bedrooms were individual, with different decorations and furnishings, people were encouraged to bring their own pieces of furniture and personal possessions. On the 2nd floor the area had been recently refurbished with cosy lounge and kitchen area. Most bedrooms were individual rooms with one double shared bedroom. The manager and staff had made this a comfortable and homely environment, but this area was enclosed and claustrophobic. This was in contrast to the open space that people experienced on the lower floors. It was discussed with the manager that this area needed to be reviewed in terms of suitability for the peoples long term needs. On the ground floor a small cafe area had been introduced for everyone to use including visitors to the home. The home was well maintained and employes a full time handyman who carries out minor repairs and health and safety checks in the home. There are also two members of staff who work to make sure the standard of the home is kept up to. Staff were aware of the need to protect peoples health. They were observed using disposable aprons and gloves appropriately and the confirmed they had attended infection control training. 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. Trained and competent staff meet peoples needs. Evidence: Positive comments were made about the staff by people who live in the home and their relatives for instance, Staff are always patient and kind. Three of the staff records were reviewed in relation to recruitment and management support. All had been recruited safely and the relevant checks completed. Also, where a person had come to work from abroad the necessary checks had been carried out from their country of origin. Staff confirmed that they have regular supervision with their senior staff and that team meetings are held. The commented that the home was well run and the atmosphere positive, One memeber of staff said, I look forward to going to work. Staff confirmed that staffing levels were good and they were able to spend time with Care Homes for Older People Page 23 of 29 Evidence: individuals and engage them in activities. Relatives also confirmed that staffing levels appeared good and that there were always staff available at their visits. The staffing rotas were reviewed for the month and confirmed a consistency in staffing levels. Staff records confirmed that people had thorough induction training that met the Skills for Care Standard. The AQAA (annual assessment questionnaire) confirmed that over 50 staff have National Vocational Qualification level two or above in care. This is important and shows that the service makes sure that staff are trained to care for people safely. Staff spoken with confirmed they had completed a variety of different training such as dementia care, protection of vulnerable adults and infection control. Staff tell us, The training given to staff is excellent. Staff have also attended a variety of other developmental training. The pre assessment information told us, Within the Memory Lane ...the team attended various workshops including matching, small group living, qualitative observations and leadership in dementia care. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Threshfield Court is run in the best interests of all the people who live there. Evidence: The Manager of Threshfield Court have been passionate and proactive in the development of dementia care within the home and this has raised the profile of Threshfield. She is an experienced nurse who has worked at the home for many years and has completed her management qualifications and is further developing her skill and knowledge in the areas of dementia care. A Deputy Manager supports her in her role and also has Management and Training qualifications and the two have worked together as a team for ten years. All the staff spoken with said they felt well supported by the managers in the home. Staff also confirmed that there were regular nurse and senior staff meetings in the home. Care Homes for Older People Page 25 of 29 Evidence: Staff tell us, I am very happy with our home and Barchester Healthcare in general, they are an excellent company to work for The staff have regular Health and Safety meetings where staff discuss any health and safety issues and review procedures. The manager confirmed all the health and safety records are kept up to date. Two areas were reviewed, these were gas and electrical safety. These areas were well maintained and safety certificates had been issued. There are six monthly meetings and satisfaction surveys for people who live in the home so they can make their views known. The home obtained its Investors in People Award, which was reviewed in January 2007 and has won an award for innovation in dementia care in October 2006. The home is part of the Barchester group and follows their quality assurance programme and the staff carry out regular internal audits. Monthly internal audits also take place with the Compliance Officer undertaking audits in line with the National Minimum Standards & Care Home Regulations. This is important to ensure that the home provides effective quality assurance and ensures good outcomes for people living at the home. 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 23 The 2nd floor area needs review to make sure that it meets peoples individual dementia needs effectively. 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. 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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