Care Home: Walberton Place Nursing Home

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What the care home does well The needs of prospective residents have been assessed before they are admitted. This means prospective residents know that their needs will be met by the care home. Care plans are drawn up for each resident using the information gathered by assessing residents needs. They include information for staff to follow to ensure residents assessed needs have been met. Care plans are also regularly reviewed and residents are consulted as part of this process. This means care plans include the wishes of residents and that up to date information is available to staff. A programme of activities is provided each week for residents to enjoy. Staff are available in sufficient numbers to meet the needs of residents. Staff have received appropriate training which gives them the knowledge and skills to provide good quality care to residents. They have also been well supported by the manager. The care home has been well managed and has been run with the best interests of residents in mind. What has improved since the last inspection? Admission procedures have been followed to ensure residents needs have been assessed before moving into the care home. Improvements have been made to the information provided in care plans for staff to follow. Staff have been provided with training in the safe handling and administration of medicines. Improvements have been made to the provision of food to ensure residents are afforded a varied, nutritious and wholesome diet. The manager regularly assesses the dependency levels of residents so that staffing levels are sufficient to meet their needs. All staff have been supervised by a more senior member of staff to ensure they are supported in their work and are competent to provide the care residents require. What the care home could do better: No requirements have been made on this occasion. Key inspection report Care homes for older people Name: Address: Walberton Place Nursing Home Yapton Lane Walberton Arundel West Sussex BN18 0AS     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: David Bannier     Date: 0 9 0 9 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 31 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 31 Information about the care home Name of care home: Address: Walberton Place Nursing Home Yapton Lane Walberton Arundel West Sussex BN18 0AS 01243554040 01243553726 walbertonplace@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross OPCO Ltd Name of registered manager (if applicable) Mrs Roma Wood Type of registration: Number of places registered: care home 34 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 to be accommodated is 34. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Walberton Place Nursing Home is a care home registered to accommodate up to 34 older people who require nursing care. Walberton Place is a large detached property, located in a rural setting near to the village of Walberton. Accommodation is provided in single bedrooms located on the ground and first floors, some of which have ensuite facilities . The communal areas, including a dining room and a lounge area are located Care Homes for Older People Page 4 of 31 Over 65 34 0 1 0 0 9 2 0 0 8 Brief description of the care home on the ground floor. A vertical lift provides access to all floors. There is an extensive garden that includes lawns and flower beds that are available to residents. Current scale of fees is from £560.00 to £750.00 per week. The service is privately owned by Southern Cross OPCO Ltd, and the registered manager is Mrs Roma Woods. The responsible individual acting on behalf of the company is Mr Barry Yarnley. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection has followed the Inspecting for Better Lives methodology and is called a key inspection as it assesses those standards determined by the Commission as key standards. This inspection will also determine the frequency of inspections hereafter. The registered provider returned an Annual Quality Assurance Assessment prior to the inspection. The information received from this document will be referred to in the report. A visit to the care home was made on Wednesday 9th September 2009. As this was an unannounced inspection we gave the manager and provider no notification of our intention to visit. We spoke with four of the 24 residents currently accommodated at Care Homes for Older People Page 6 of 31 the care home and observed care practices. We also spoke with a relative who was also visiting the care home. This helped us to form an opinion of what it is like to live in this care home. We also spoke to five staff who were on duty in order to gain a sense of how it is like to work at the care home. We also viewed some of the accommodation and examined some records. The visit started at 9.30am and was completed by approximately 5.30pm. The registered manager, Mrs Roma Wood was present during our visit and provided us with information about the service. We gave feedback of our findings to Mrs Wood at the end of our visit. Care Homes for Older People Page 7 of 31 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 Care Homes for Older People Page 8 of 31 order line 0870 240 7535. Care Homes for Older People Page 9 of 31 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 31 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 care needs of all prospective residents are assessed before they are admitted. Evidence: From evidence found during our last visit we formed a judgement that pre admissions assessments varied in quality. We advised the manager that a more consistent approach to the assessment process would improve the information available to staff to assist them in meeting peoples needs. We made a requirement that the registered person must ensure as full needs assessment is undertaken for each prospective resident before they move into the care home. During this visit we examined the care records of four residents, two of whom had been admitted since our last inspection. We found evidence that the manager had made the necessary improvements to ensure more consistency. The needs of each resident had been assessed prior to admission as required. Areas of need assessed included personal care, physical wellbeing, mental state and cognition, mobility and Care Homes for Older People Page 11 of 31 Evidence: dexterity, sight, hearing and communication, oral health and foot care, continence, social interests, hobbies, religious and cultural needs. We spoke to four care staff who were on duty. They were able to explain clearly their understanding of the needs of recently admitted residents. They informed us that they had been made aware of the needs of residents via care plans and daily meetings with trained nurses. We also spoke to four residents and a relative during our visit. They confirmed that their care needs had been assessed and discussed with them before admission. The AQAA stated that A pre admission assessment is performed by the manager or competent registered nurse to ensure all individual needs can be met. This assessment is then placed in the service users care plan, which is completed on admission. We could find no evidence that Walberton Place provides intermidiate care. Care Homes for Older People Page 12 of 31 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. Care plans have been drawn up for each resident. They set out the needs of each resident and the action staff should take to ensure they have been met. Residents health care needs have also been met. Residents have been protected by the homes policies and procedures for dealing with medicines. Residents have been treated with respect and their right to privacy has been upheld. Evidence: From evidence found during our last inspection we judged that improvements were required to the care planning process to ensure the health and well being of residents. We sampled a selection of care records during this visit and found that improvements had been made as required. Residents care records include care plans which have been drawn up from the information gathered at the pre admission assessment. Care Care Homes for Older People Page 13 of 31 Evidence: plans include details of residents identified needs together with clear information for staff to follow so they know the action they are expected to take to ensure they have been met. Following discussion with the manager we identified small areas where care plans could be improved further to ensure information is clearer for staff. There was evidence that confirmed care plans have also been routinely reviewed. This means that information about residents care needs is kept up to date. We noted that residents, or their relatives sign the care plan to confirm it has been discussed with them and it is in accordance with their wishes. Residents we spoke to confirmed that they are aware of the content of care plans and they are consulted before any amendments are made. They also informed us they were very satisfied with the care provided. Their needs were met by the actions of staff, and their wishes had been taken into account. Care records also include details of appointments with residents doctors or other health care professionals including details of any treatment prescribed and provided. We spoke to care staff who were on duty. They were able to demonstrate they were familiar with the needs of identified residents and the actions they should take to ensure they have been met. Information provided in the AQAA confirmed that, Each service user has person centred care and an individual care plan, which is reviewed monthly, or when a change in care arises, to ensure health care continues to be met. The home has established good relationships with the multidisciplinary team and seeks advice from and makes referrals to as required e.g. SALT, dietician, social workers etc. Recommendations are implemented and recorded in care plans. During our last visit we found evidence that residents are treated with dignity and their right to privacy is respected. On this occasion we observed care practices and found that staff are respectful when speaking to residents and ensure residents are treated with dignity when personal care is being provided. Staff were seen to address residents using the name and title they prefer. Staff were seen to knock on the doors to residents private accommodation and wait for a response before entering. We noted that, when residents are receiving personal care in their rooms, a sign is put on the door informing them the resident is receiving care and is unavailable. The sign also asks the visitor to return later. We spoke to several residents during our visit. They informed us they felt well treated by the staff. Care Homes for Older People Page 14 of 31 Evidence: Information provided in the AQAA confirmed that, All service users are treated with respect and dignity in line with policies and procedures. Staff are instructed on how to address people correctly, knocking on service users doors, respecting and maintaining peoples privacy. We looked at care records and medication records. We were satisfied that medication records had been well maintained and were up to date. We also noted that a secure facility had been provided to store all medication.We noted that staff who handle medication had been provided with up to date and appropriate training. We observed the trained nurse on duty adminstering medication over the mid day meal. Medication was administered from a trolley which was locked when the nurse was not present. Medication was taken to each resident, whether they were in the dining room or in their own room. Care Homes for Older People Page 15 of 31 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. Residents find the lifestyle experienced in the home matches expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Residents maintain contact with family, friends, representatives and the local community as they wish. Residents are helped to exercise choice and control over their lives. Residents receive a wholesome appealing balanced diet which meets individual residents nutritional needs. Evidence: During our last visit we formed a judgement that more consistency was required in the provision of activities. This would improve the lives of people living in the home. During this visit we noted that care records include details of each residents interests and hobbies. We were informed that an activities coordinator has been appointed who is responsible for organising activities for residents to enjoy. We were also informed that there is programme of activities which are arranged on a daily basis. We were shown a copy of previous weeks activities programme and noted they included a Care Homes for Older People Page 16 of 31 Evidence: gardening club, exercise sessions, quizzes, music sessions and visits by dogs and their owners. Representatives of the local church visit regularly to enable those that wish to receive communion . The programme is also on display on a notice in the front hallway of the care home. Also on display were photographs of a recent charity event which included a dog show and barbecue in the grounds. During the afternoon of our visit we observed nine residents enjoying a movement to music exercise session. Residents we spoke to informed us that, whilst they enjoyed the activities that had been organised, they were able to choose if they wished to take part in them. One resident told us they enjoy taking part when the dogs visit with their owners. Otherwise they are not interested. The AQAA confirmed, We have undertaken social profiling of each service service user, identifying specific likes and dislikes and opportunity for one to one activities. The activities we provide are well formulated and are held in groups or as one to one sessions. We try to provide meaningful activities, which actively promotes choice and enjoyment. During our last visit we found evidence which confirmed that residents have been supported in maintaining contact with their family and friends. Visitors were made welcome in the home at any reasonable time. During this visit we noted that care records include details of residents families and next of kin, including telephone numbers, so that they may be contacted. Residents we spoke to confirmed that they are able to keep in touch with family and friends. We also spoke to a relative who informed us they visit most days and was able to confirm they are made welcome by the manager and her staff. Information in the AQAA confirmed, Families and visitors are encouraged to participate in activities in the home and to feedback information about service users. During our last visit we formed a judgement that improvements were required to the meals provided. We spoke to the cook during this visit who told us about the main meal of the day that was being prepared. This consisted of a choice of lasagne or ham salad followed by a choice of lemon sponge pudding with custard or fresh fruit. Alternatives such as jacket potatoes and omelettes were also available for those residents who required a lighter meal. The cook also informed us of the special diets that were currently being catered for. This included diets for residents who are diabetic and also those who required Care Homes for Older People Page 17 of 31 Evidence: liquidised meals. We were given copies of recent menus to look through. They demonstrated that a varied, wholesome and nutritious diet has been provided. We observed the main meal of the day being served. We noted that tables in the dining room had been attractively presented with linen tablecloths and napkins, condiments, a choice of cold drinks and individual place settings. Menus were on display in the dining room and position so that residents are able to view them. We were informed that some residents have chosen to taken their meal in their rooms. The meal was served out from a heated cabinet and was attractively presented to encourage residents appetite. Residents we spoke to during the meal confirmed the meal was tasty and nicely cooked. We also spoke to other residents who confirmed they were satisfied with the food provided. A suggestions or comment book is available to residents in the dining room. The manager informed us this had been introduced in June 2009. We noted that recent comments included I like the fish, but not with batter. I prefer it bread crumbed, and The liver tasted strong and bitter. The manager informed us the cook does read such comments and takes them into account when planning menus. The AQAA confirmed, We provide individually tailored meals as required. Care Homes for Older People Page 18 of 31 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 and their relatives are confident that their complaints will be listened to, taken seriously and acted upon. Residents are protected from abuse. Evidence: During our last visit to Walberton Place we formed a judgement that the people who use the service are able to complain and are protected by the homes policies for safeguarding them. On this occasion we noted that the homes complaint procedure was on display in the front hallway of the care home. Residents we spoke to during our visit confirmed they knew who to speak to if they wished to make a complaint. They also confirmed they were confident their concerns would be listened to and taken seriously. One resident commented, If I needed to make a complaint I would speak to the manager. She is quite approachable. Information in the AQAA confirmed that, Provision of information with regard to complaints policy and procedure and CQC contact information is available in reception and in all service users rooms Staff are made aware of the complaints policy and procedure. The AQAA also confirmed eight complaints have been received over the Care Homes for Older People Page 19 of 31 Evidence: past 12 months. They have all been resolved to the satisfaction of the person making the complaint within agreed timescales. During this visit we spoke to some staff who were on duty. They confirmed they have received training with regard to identifying different types of abuse. Following discussion the staff were able to demonstrate they knew the different categories of abuse that they might encounter. They were also able to explain who they should notify if they witnessed an incident where a resident had been abused. We also examined records of staff training which confirmed they had received training in this area. Residents we spoke to confirmed they were satisfied with the quality of care provided. They also confirmed they felt they were in safe hands. The AQAA also confirmed, All staff receive training in adult protection and whistle blowing and have access to all guidance, policies and procedures. Care Homes for Older People Page 20 of 31 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. Residents are living in a safe, well-maintained environment. The home is clean, pleasant and hygienic Evidence: During our last visit we found evidence which confirmed that residents live in a safe, well maintained environment. We looked at the private accommodation of several residents along with the communal areas, including the dining room and the lounges. These areas were clean, decorated and furnished in a comfortable manner that met the needs of the residents accommodated. Residents have been encouraged to bring personal effects and small items of furniture in order to make bedrooms as individual as possible. Residents we spoke to told us they were satisfied with their accommodation. We also visited the kitchen area, the laundry, and several bathrooms. We noted that these areas have been maintained to a good standard of cleanliness. Information within the AQAA confirmed, Robust policies and procedures are in place for maintenance within the home. Maintenance staff perform daily, weekly and monthly safety checks following legislative guidelines, which is audited by the home Care Homes for Older People Page 21 of 31 Evidence: manager and operations manager monthly. A dedicated team of housekeeping staff complete daily and weekly cleaning records. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers and skill mix of staff meet residents needs. Residents are in safe hands at all times. Residents are supported and protected by the homes recruitment policy and practices. Staff are trained and are competent to do their jobs. Evidence: During our last visit we formed a judgement that staffing levels need to be addressed to ensure adequate staff numbers are on duty ensure the health and safety of residents. During this visit we examined a selection of staff rotas. They showed that there is a trained nurse on duty 24 hours a day. From 8am to 2pm the trained nurse is supported by at least five care assistants; some mornings there are six care assistants. From 2pm to 8pm the trained nurse is supported by four care assistants. From 8pm to 8am each night care is provided to residents by a trained nurse and three care assistants who are awake and on duty. In addition to the care staff there are housekeeping staffing, including chefs and Care Homes for Older People Page 23 of 31 Evidence: domestic staff who are responsible for the providing meals to residents and for keeping the premises clean. The manager informed us that she uses a form to assess the dependency level of each resident. We noted that a completed form was present in each of the care records seen. The manager also advised us this is used to work out the staffing levels required to ensure all residents needs are met. Residents we spoke to during our visit confirmed they are very satisfied with the care provided. One resident told us, The staff are very good. I have a bell if I want anything. They will come running in to see what I want. They also come in to see if I am alright. Another resident commented, I am quite happy with the care. I think they need more staff, but they are very good. From evidence seen in care records, discussions with residents and direct observations of care provided we concluded there were sufficient staff on duty to meet the current needs of residents. During our last visit we judged that staff receive suitable training, however regular supervision would ensure their competency. During this visit we looked at staff training records. They demonstrated that newly appointed staff undertake structured induction training. This includes providing an understanding of the principles of good care practices and covers the promoting of residents rights, independence, choice and dignity. Training records also provided evidence that confirmed staff have been provided with mandatory training including fire safety, health and safety, manual handling and food hygiene. The AQAA confirmed, All staff have equal opportunities to undertake training and maintain a good skill mix within the staff team. Mandatory training is in place for adult protection, fire safety, food hygiene, health and safety, and moving and handling. The AQAA also confirmed that, of the 20 permanent care workers employed, nine have obtained the National Vocational Qualification (NVQ) in Care or Health and Social care at Level 2 or above. We spoke a group of staff who were on duty. Following discussion, they told us about their role in the care home, the training they have undertaken, their understanding of the needs of identified residents and the action they are expected to take to ensure residents needs have been met. Care Homes for Older People Page 24 of 31 Evidence: Staff on duty who we spoke to confirmed they receive supervision every two months and attend staff meetings regularly. They also confirmed they felt well supported by the management. The manager showed us recent records of supervision sessions together with a record of sessions planned to take place in the future. The AQAA confirmed, All staff receive supervision. We looked through the recruitment records of three staff who have been appointed since our last visit. These records demonstrated that the registered providers have obtained appropriate checks for staff, including criminal records checks, written references and proof of each persons identity. Where necessary, there was evidence that confirmed that, before appointment, the registration of trained nurses have been checked with the Nursing and Midwifery Council (NMC). The AQAA also confirmed, There are robust policies and procedures in place for recruitment. Trained nurses are checked with the NMC to ensure current registration. Care Homes for Older People Page 25 of 31 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. Residents live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge her responsibilities fully. The home is run in the best interests of residents. Residents financial interests are safeguarded. The health, safety and welfare of residents and staff are promoted and protected Evidence: Mrs Roma Wood has registered with us as the manager since our last visit. She has demonstrated she has the necessary skills, knowledge and experience to manage a care home for elderly people whose needs include nursing care, such as Walberton Place. We were shown copies of minutes and an agenda of residents meetings. They Care Homes for Older People Page 26 of 31 Evidence: demonstrated they take place regularly and residents relatives are able to attend if they wish. Meetings include discussions about activities and planned outings or seasonal events such as the recent barbecue and charity event. There is also an opportunity for residents to raise issues regarding the day to day running of the home. We spoke to the relative of one resident who confirmed that such meetings are held regularly. They also informed us that, whilst the management uses such meetings to communicate with them, there is also ample opportunity for residents and their families to share ideas, opinions and concerns with the manager. We were also shown minutes of staff meetings. They also demonstrated they are held regularly and that the manager uses them as a means of communicating with the staff of the care home. We were also shown records which demonstrated that all staff have attended individual supervision sessions on a regular basis. This ensures they receive the support the require and there is a means of identifying training needs for each member of staff. The AQAA confirmed that, The manager is a registered nurse (Level 1) who has been in post since August 2008. She has successfully completed her Registered managers Award (RMA). The home manager has an open door approach to enable service users, their families to see her at any time. There are regular resident, relatives meetings. The registered provider has set up a quality assurance system to be used throughout their care homes. We saw evidence that this was in use at Walberton Place. The manager is expected to carry out monthly audits on various areas about the the day to day management of the care home. We were shown audit reports carried out on the administration of medication and accidents and incidents which have occurred over the past month. The manager informed that, with regard to medication, she is expected to review records and assess practices against national minimum standards and award a score. We were informed, when the manager assess accidents and incidents, she is expected to look for trends and reasons why they have occurred. This information is then used to review policies and practices to determine if improvements are needed. Representatives of the registered provider also visit the home on a monthly basis to monitor and evaluate how well the home is being managed. We examined copies of the reports of such visits. They confirmed that they had been undertaken regularly and had been used to monitor the service provided. The AQAA confirmed, The operations manager visits at least monthly and regular meetings are held. They offer support, supervision and completes Regulation 26 reports. Accidents and incidents are recorded and audited monthly. Internal audits are Care Homes for Older People Page 27 of 31 Evidence: completed by the home manager. We did not examine records of monies kept by the care home on behalf of residents during this visit. However, residents we spoke to informed us that either a friend or relative deals with their finances on their behalf. The AQAA confirmed, Service users monies are dealt with by the financial administrator and audited by the home manager and operations manager. During this visit we noted that the premises had been well maintained. There was no evidence that the property or equipment seen put at risk the safety and wellbeing of residents or staff. Information supplied in the AQAA confirmed the registered provider has taken appropriate steps to ensure the premises and equipment within the care home is safe for use. For example, gas and electrical appliances have been checked and maintained regularly. We found evidence that a programme of training provided to all staff includes health and safety issues, fire prevention, manual handling and first aid. Information provided in the AQAA also confirmed, Health and safety and welfare of service users are promoted and protected at all times, through regular meetings, one to one meetings, supervision, training and regular audits. Care Homes for Older People Page 28 of 31 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 29 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 30 of 31 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. 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